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Adirondack  Cottage  Sanitariam,  Trudeau,  N.  Y.     The  Original  One-room  Cottage  witere 
Dr.  Edward  L.  Tkudeau  began  his  Experiment  with  the  Open-air  Treatment 

OF  Tuberculosis. 


Tuberculosis 

Hospital  and  Sanatorium 

Construction 


WRITTEN  FOR 

THE  NATIONAL  ASSOCIATION  FOR 

THE  SVUDY  AND  PREVENTION  OF 

TUBERCULOSIS 


BY 
THOMAS  SPEES  CARRINGTON,  M.D. 


ASSISTANT    SECRETARY 


NEW  YORK 
105  EAST  TWENTY-SECOND  STREET 

1911 


rLLT. 


,/^ 


\,y 


# 


:i>ti!vnv 


Prefa 


ce 


The  present  work  is  an  expansion  of  the  pamphlet  issued  two  years  ago  by 
the  National  Association  for  the  Study  and  Prevention  of  Tuberculosis  in  response 
to  a  pressing  demand  for  information  and  advice  in  the  establishment  of  sanatoria 
and  hospitals. 

During  this  period  the  emphasis  of  the  campaign  has  been  laid  particularly 
upon  the  importance  of  increasing  our  equipment  for  the  institutional  care  of  tu- 
berculous patients.  The  response  has  exceeded  expectation  and  has  been  par- 
ticularly encouraging  in  the  degree  to  which  local  and  state  governments  have 
accepted  responsibility  for  the  situation.  Under  these  conditions  the  problem  of 
tuberculosis  from  the  institutional  point  of  view  is  to  care  for  the  largest  possible 
number  of  patients  at  the  lowest  possible  cost  compatible  with  efficient  results. 

While  it  is  true  that  institutional  expense  is  much  more  a  matter  of  main- 
tenance than  of  original  cost  of  construction  it  is  equally  true  that  careful  prelim- 
inary planning  is  the  chief  factor  in  subsequent  economy  of.  operation.  It  is  with 
this  end  in  view  that  the  following  study  has  been  prepared. 

It  is  hoped  that  the  book  will  prove  of  service  to  those  charged  with  the 
responsibility  of  dealing  with  the  institutional  problem  in  their  several  communities. 

Livingston  Farr.\nd, 

Executive  Secretary. 

May  ijlli,  iQii 


2HU0H 


Contents 


Introduction 
Section      I. 


II. 


III. 


IV 


V. 


VI. 


Site  and  Grouping  ........ 

Sanatorium  Sites;  Transportation  Facilities;  Extent  and  Nature  of  the  Land; 
Lighting,  Water  and  Sewage;  Meterological  Conditions;  Natural  Beauty;  Ex- 
amination of  the  Land;  Farm  Buildings;  Grouping;  Cleaning  and  Apportioning 
Grounds;  Railroad  Station;  Buildings  and  Improvements  for  Block  Plan;  Sites 
for  Hospitals  to  House  Advanced  Cases;   Examples  of  Grouping  and  Sites. 

Administration  Buildings         ....... 

Methods  of  Sanatorium  Administration;  Planning  Administration  Buildings; 
Class  and  Number  of  Patients;  Staff  and  Servants'  Housing;  Staff  and  Ser- 
vants' Salaries;  Service  Buildings;  Amusement  Pavilions;  Industrial  Buildings; 
Water  Supplies;  Light,  Heat  and  Power;  Laundries;  Sterilizing  Rooms;  Vacuum 
Cleaning  Plants;  Ice  Houses  and  Cold  Storage  Plants;  Carpenter  and  Paint 
Shops;  Store  Houses,  Bakeries  and  Scale  Houses;  Green  Houses,  Forcing  Beds, 
Vegetable  Cellars;  Garages,  Barns  and  Stables;  Farm  Outfits;  Cow-barns;  Silos; 
Milk  Houses;  Chicken  and  Hog  Houses;  Sewage  Disposal  Plants;  Examples 
of  Administration  Buildings;   Examples  of  Service  Buildings. 

Administration  Buildings  and  Patients'  Quarters  Combined 

Suggestions  for  Planning  Buildings;  Examples  of  Complete  Institutions  under 
One  Roof. 

Hospitals    for    Advanced    Cases.     Infirmaries    and    Reception 
Hospitals        ......... 

Description  of  Hospitals  for  Advanced  Cases;  Description  of  Infirmaries;  De- 
scription of  Reception  Hospitals;  Examples  of  the  Buildings  at  Various  Institu- 
tions. 

Patients'  Quarters.     Lean-to  Type  of  Building 

Origin  of  These  Buildings;  Material;  Finish;  Excavation;  Exposure;  Arrange- 
ment of  Floor  Plans;  Porch  Space;  Porch  Protection;  \'cntilation;  Fixtures; 
Plumbing;    Examples  of  Lean-tos. 

Patients' Quarters.     Cottage  Type  of  Building. 

Origin  of  These  Buildings;  Points  to  be  Considered  in  Designing  Cottages;  E.\- 
amples  of  Cottages. 


PAGE 

17 


37 


69 


89 


117 


147 


Illustrations 


Frontispiece — Dr.  Trudeau's  Original  Cottage. 


No. 


3 

4 
5 
6 

7 

8 

9 

lO 

II 

12 


SECTION  I 

Site  and  Grouping 

Loomis  Sanatorium,  Liberty,  N.  Y., 

Views  of  a  Farmhouse  before  and  aftei:  Remodeling 
Mews  of  Land  Showing  Natural  Features 

of  Value  on  Sites  for  Sanatoria 
Maryland  State  Sanatorium,  Sabillasville,  Md., 

Bird's-eye  View  ..... 
Georgia  State  Sanatorium,  Alto.  Ga., 

Block  Plan 

Waverly  Hill  Sanatorium,  Waverly  Hill,  Ky., 

Front  Elevation  and  Block  Plan    . 
Agnes  Memorial  Sanatorium,  Denver,  Colo., 

Front  Elevation  and  Block  Plan    . 
Indiana  State  Hospital,  Rockville,  Ind., 

Bird's-eye  View  and  Block  Plan 
Portland  Open  Air  Sanatorium,  Portland,  Ore., 

Block  Plan  .      .  , 

\'ermont  State  Sanatorium,  Pittsford,  Vt., 

View  of  Front  Elevation  and  Block  Plan 
Esse.x  County  Tuberculosis  Hospital,  Soho,  N.  J., 

\'iew  of  Buildings  and  Block  Plan 
Maine  State  Sanatorium,  Hebron,  Me., 

Block  Plan  .  . 

Preventorium  for  Children,  Farmingdale,  N.  J., 

Bird's-eye  View  of  Building  and  Block  Plan 


PAGE 
20 
22 
26 
27 
28 
29 

30 
31 
32 

33 
34 
35 


SECTION  II 

Administr.ation  Buildings 

13  Adirondack  Cottage  Sanitarium,  Saranac  Lake,  N.  Y., 

Amusement  Pavihon;   Views  and  Plans.  .  .  .  . 

14  Municipal  Sanatorium,  Otisville,  N.  Y., 

Servants'  Open  .\ir  Sleeping  Pavilion     ..... 

15  An  Open  Air  Dining  Room     ........ 

16  Portland  Open  Air  Sanatorium,  Portland,  Ore., 

Amusement  Pavilion;   Interior       ...... 

17  Catawba  Sanatorium,  Catawba,  \'a., 

A  Method  of  Storing  Water ....... 

18  Waverly  Hill  Sanatorium,  Wavc^-ly  Hill,  Ky., 

View  from  Rear  of  Buildings  Showing  Power  House 

19  Preventorium  for  Children,  Farmingdale,  N.  J., 

Power  House  and  Laundry;   Elevations  and  Floor  Plans. 

20  District  Tuberculosis  Hospital,  Lima,  Ohio, 

Floor  Plan  of  Basement  Showing  Arrangement  of  Power  Plant 

21  A  Rectangular  Steam  Disinfecting  Chamber     ..... 

22  Eudowood  Sanatorium,  Towson,  Md., 

.\dministration  Building;   View  and  Floor  Plans 

23  Maine  State  Sanatorium,  Hebron,  Me., 

.\dministration  Building;   View  and  Floor  I'lans 

24  Iowa  Stale  Sanatorium,  Oakdale,  la.. 

Administration  Building;   View  and  Floor  Plans 

25  Manit()l)a  Sanatorium,  Ninette,  Manitoba,  Canada, 

.\(hninistrali()n  iiuilding;   \'iews  and  Floor  Plans 

26  Indiana  State  H()s])ilal.  Roikville,  Ind., 

.\dministration  Building;   \'iew  and  Floor  Plans 

27  Preventorium  for  Children,  Farmin'j;dale,  N.  J., 

.Administration  Building;   Elevation  and  Floor  I'lans 


40 

41 
42 

43 
44 
46 

47 

48 
50 

55 
57 
58 

59 
61 
62 


10 


Illustrations 

No.  PAGE 

28  Municipal  Sanatorium,  Otisville,  N.  Y., 

Service  Building;   View  and  Floor  Plans  ........        64 

29  Iowa  State  Sanatorium,  Oakdale,  la., 

Service  Building;   \'iews  and  Floor  Plans        ........        65 

30  Catawba  Sanatorium,  Catawba,  \'a., 

Sersice  Building;    Elevation  and  Floor  Plan    ........        66 

31  New  Haven  County  State  Sanatorium,  Meriden,  Conn., 

Ser\-ice  Building;   \'iew  and  Floor  Plans  ........       67 

SECTION  III 
Administration  Buildings  and  Patients'  Quarters  Combined 

32  Eastern  Maine  Hospital,  Bangor,  Me., 

Method  of  Protecting  Sleeping  Porch  with  Wire  Netting.  .  .  .  .  71 

^■^         U.  S.  Hospital  for  Insane,  Washington,  D.  C, 

Method  of  Enclosing  Porch,  with  Swinging  Sash  Frames.  .  .  -71 

34         Sharon  Sanatorium,  Sharon,  Mass., 

View  and  Floor  Plan  .  .  .  .  .  .  .  .72 

^^         Tuberculosis  Hospital,  Washington,  D.  C, 

\'iew  of  F"ront  Elevation        ...........        74 

36  Tuberculosis  Hospital,  Washington,  D.  C, 

Floor  Plans  .............        75 

37  Lady  Grey  Hospital,  Ottawa,  Canada, 

\'iew  and  Floor  Plans  .  .  .  .  .  .  .  .  .  .  -77 

38  Lake  Edward  Sanatorium,  Lake  Edward,  Quebec,  Canada, 

\'iew  and  Floor  Plans  ............        79 

39  Franklin  County  Tuberculosis  Hospital,  Columbus,  Ohio, 

Elevation  and  Floor  Plans  .  .  ■         .  .  .  .  .  .81 

40  Hartford  County  Tuberculosis  Sanatorium,  Hartford,  Conn., 

\'iew  and  Floor  Plans  ............        83 

41  Cuenca  Sanatorium,  Bass  Lake,  ]\Iinn., 

Elevation  and  Floor  Plans    ...........        84 

42  Association  Sanatorium,  Colorado  Springs,  Colo., 

Elevation  and  Floor  Plans    ...........        85 

43  District  Tuberculosis  Hospital,  Lima,  Ohio, 

Mews  and  Floor  Plan  ............        86 

44  .\  Design  for  a  Small  Town  or  Village  Hospital, 

Ele\'ation  and  Floor  Plan      ...........        88 

SECTION  IV 
Hospitals  for  .Advanced  Cases — Infirmaries  .\nd  Reception  Hospitals 

45  Comparison  of  the  Floor  Plans  of  Infirmaries,  Reception  Hospitals,  and 

Buildings  Hou.sing  .Vch^anced  Cases    .........        90 

46  Indiana  State  Hospital,  Rockville.  Ind.. 

.V  Method  of  Connecting  Rooms  with  Open  Porches         ......       92 

47  Isolation  Hospital,  Pater.son,  N.  J., 

.\  Method  of  Heating  Porches  for  .\dvanced  Cases.  ......        93 

48  Riverside  Hospital,  New  York  City. 

Concrete  Pa\ilion;    Elevation  and  Floor  Plans  .......        05 

49  Jewish  Hosjjital  for  Consumptives,  Reisterstown.  Md., 

PaNdlion  for  Advanced  Cases;   Views  of  Elevations     .......        96 

50  Jewish  Hospital  for  Consiunptives,  Reisterstown,  Md., 

Pavilion  for  Ach'anced  Cases;    I'"loor  Plans      .  .  .  .97 

51  Indiana  State  Hospital,  Rockville,  Ind., 

Pavilion  for  .Vihanced  Cases;   \'iew  and  Floor  Plans         ......        98 

52  Isolation  Hospital,  Paterson,  N.  J., 

Pa\ilion  for  .\d\anced  Cases;   \'iew  and  Floor  Plans         ......       99 

53  LTnited  States  .\rmy  General  Hospital,  Ft.  Bayard,  N.  M., 

Officers'  Quarters;   \'iew  and  Floor  Plan  ........      100 

54  United  States  .\rmy  General  Hospital,  Ft.  Bayard,  N.  M.. 

Enlisted  Men's  Ward  No.  2;   \'iew  and  Floor  Plan.  ......      loi 

55  United  Stales  .Vrmy  General  Hospital,  Ft.  Bayard,  N.  M., 

Enlisted  Men's  Ward  No.  2;  View  of  Inner  Court  ......      102 

56  Lakeville  Tuberculosis  Hospital.  Middleboro.  Mass., 

Pa\ilion  for  .\d\anced  Cases;   \"iew  and  Floor  Plan  ......      103 

57  Boston  Consumptives  Hosjiital,  Maltajian,  Mass., 

Ward  for  Advanced  Cases;   \'iew  and  Floor  Plan     .  .  .  .  .104 

58  Maine  State  Sanatorium,  Hebron,  Me., 

Inlirmary;   \'iew  and  Floor  Plan   ..........      105 

II 


Illustrations 


No. 

59  Municipal  Sanatorium.  Otisvillo.  N.  Y., 

Infirmary;   \ic\vs  of  Front  and  Rear  Elevations 

60  Municipal  Sanatorium,  Otisville,  N.  Y., 

Infirmary;    Floor  Plans         ...... 

61  Eudowood  Sanatorium,  Tovvson,  Md., 

Infirmary;    \'ie\vs  and  Floor  Plan 

62  Edward  Sanatorium,  Xai)or\ille,  111., 

Infirmar>-  and  Medical  Building;   Yiew  and  Floor  Plans 

63  Adirondack  Cottage  Sanitarium,  Saranac  Lake,  N.  Y., 

Infirmary  and  Medical  Building;   Yiew  and  Floor  Pliins 

64  Maryland  State  Sanatorium,  Sabillas\ille,  Md., 

Infirmary;   Yiew  and  Floor  Plans 

65  Georgia  State  Sanatorium,  .Vlto,  (la.. 

Infirmary;   \'iew  and  Floor  Plan    .... 

66  Danvers  State  Hospital,  Hawthorne,  Mass., 

Pavilion;   \'iew  of  Elevation  and  Floor  Plan  . 

67  Ohio  State  Sanatorium,  Mt.  Yernon,  Ohio, 

Reception  Hospital;   View  and  Floor  Plan       .  . 


106 


.  107 

108 

.  no 

III 

112 

.   113 

.   114 

.  IIS 

SECTION  V 

Patients'  Quarters — Lean-to  Type  of  Building  for  Incipient  Cases 

68  Comparison  of  Floor  Plans  of  the  Lean-to  Type  of  Buildings 

for  Housing  Incipient  Cases         .... 

69  Catawba  Sanatorium,  Catawba,  Va., 

An  Open  Porch  Illustrating  Simplicity  of  Construction 

70  North  Reading  State  Sanatorium,  North  Reading,  Mass., 

An  Open  Porch  Illustrating  a  Method  of  Protection 

71  Virginia  State  Farm,  Richmond,  \'a.. 

Open  Porch,  Illustrating  a  Method  of  Protection     . 

72  Loomis  Sanatorium,  Liberty,  N.  Y., 

Open  Porch,  Showing  a  Method  of  Interior  Finish  . 

73  Loomis  Sanatorium,  Liberty,  N.  Y., 

Lean-to;   Yiew  and  Floor  Plan       .... 

74  Michigan  State  Sanatorium,  Howell,  Mich., 

Lean-to;  View  and  Floor  Plan      .... 

75  Maryland  State  Sanatorium,  Sabillasville,  Md., 

Lean-to;  View,  Cross-Section  and  Floor  Plan 

76  Delaware  State  Sanatorium,  Wilmington,  Dela., 

Lean-to;  Yiew  and  Floor  Plan       .... 

77  Ohio  State  Sanatorium,  Mt.  Vernon,  Ohio, 

Lean-to;  View  and  Floor  Plan      .... 

78  Georgia  State  Sanatorium,  .\lto,  Ga., 

Design  for  a  Lean-to    ...... 

79  New  Haven  County  State  Sanatorium,  Meriden,  Conn., 

Lean-to;  View  and  Floor  Plans     .... 

80  Catawba  Sanatorium,  Catawba,  Va., 

Lean-to;  View  and  Floor  Plan       .... 

81  Manitoba  Sanatorium,  Ninette,  Manitoba,  Canada, 

Lean-to;  View  and  Floor  Plan       .... 

82  Edward  Sanatorium,  Naperville,  111., 

Lean-to;  View  and  Floor  Plan       .... 

83  Eudowood  Sanatorium,  Towson,  Md., 

Lean-to;  Yiew  and  Floor  Plans     .... 

84  Iowa  State  Sanatorium,  Oakdale,  la.. 

Lean-to;  \'iew  and  Floor  Plan       .... 

85  Municipal  Sanatorium,  Otisville,  N.  Y., 

Lean-to;  View  and  Floor  Plan       .... 

86  Association  Sanatorium,  Louisville,  Ky., 

Lean-to;  View  and  Floor  Plan       .... 

87  North  Reading  State  Sanatorium,  North  Reading,  Mass., 

Lean-to;    View,  Cross-Section  and  Floor  Plan 

88  Edward  Sanatorium,  Naperville,  111., 

Lean-to;   View  and  Floor  Plan       .... 

89  Iowa  State  Hospital,  Mt.  Pleasant,  la.. 

Lean-to;   Elevation  and  Floor  Plan 

90  Rush  Hosfiital,  Country  Branch,  Malvern,  Pa., 

Lean-to;   \'icw  and  Floor  Plans     .... 

91  Loomis  Sanatorium,  Liberty,  N.  Y., 

Lean-to;   View  and  Floor  Plan      .... 


118 
120 
121 
122 
123 
124 

125 
126 
127 
128 
129 
130 

131 
132 

133 
134 

13s 
136 

137 
138 

139 
140 

141 
142 


12 


Illustrations 


No. 
92 

93 
94 
95 


96 

97 
98 

99 

100 

lOI 

102 

103 
104 

105 
106 
107 
108 
109 
no 


Michigan  State  Sanatorium,  Howell.  Mich., 

Design  for  a  Lean-to    .... 
New  York  State  Hospital,  Raybrook,  N.  Y., 

Design  for  a  Lean-to    .... 
Municipal  Sanatorium,  Otisville,  X.  Y., 

Lean-to;   \'iew  and  Floor  Plans 
Preventorium  for  Children,  Farmingdale,  X.  J.. 

Lean-to;   Elevation  and  Floor  Plans 


SECTIOX  VI 
P.vTiENTs'  Quarters — Cott.\ge  Type  of  Building 


Millet  Sanatorium,  East  Bridgewater,  Mass., 

Cottage;   View,  Cross-Sections  and  Plans 
Rush  Hospital,  Country  Branch,  Malvern,  Pa., 

Cottage;   \'iew  and  Floor  Plan 
Adirondack  Cottage  Sanitarium.  Saranac  Lake,  X'^.  Y., 

Cottage;   \'iew  and  Floor  Plan 
Association  Sanatorium,  Louisville,  Ky., 

Cottage;   View  and  Floor  Plan 
White  Haven  Sanatorium,  White  Haven,  Pa., 

Cottage;   \'iew  and  Floor  Plan 
Municipal  Sanatorium,  Otisville,  X'.  Y.. 

Cottage;   \'iew  and  Floor  Plan 
Plainfield  General  Hospital,  Plainfield,  X.  J., 

Cottage;   Mew  and  Floor  Plan 
Iowa  State  Sanatorium,  Oakdale,  la.. 

Cottage;   Mew  and  Floor  Plan 
Adirondack  Cottage  Sanitarium,  Saranac  Lake,  X.  Y., 

Wheeler  Cottage;   \'iew  and  Floor  Plan 
Gaylord  Farm,  Wallingford,  Conn., 

Connected  Cottages;  View  and  Floor  Plans 
Barlow  Sanatorium,  Los  .\ngeles,  Cal., 

Cottage;   \'iew  and  Floor  Plan 
Portland  Open  Air  Sanatorium,  Portland,  Ore., 

Cottage;   \'iews  ..... 
Loomis  Sanatorium,  Liberty,  X.  Y., 

Orchard  Cottage;   \'icw  and  Floor  Plan 
Adirondack  Cottage  Sanitarium,  Saranac  Lake,  X.  Y., 

Xathan  Cottage;   \'ie\v  and  Floor  Plan. 
River  Pines  Sanatorium,  Stevens  Point,  Wis., 

Cottage;  Mew  and  Floor  Plan 


143 
143 
144 

145 


149 
150 
151 

15^ 
153 
154 
155 
156 
157 
158 
159 
160 
162 
163 
164 


13 


Introduction 


It  is  hoped  that  this  work  will  be  found  useful  by  those  who  desire  to  design  and 
construct  hospital  and  sanatorium  buildings  for  the  care  of  tuberculous  patients. 

The  information  presented  has  been  collected  during  a  series  of  investigations  into 
the  methods  and  materials  used  in  the  construction  of  buildings  at  various  institutions 
where  patients  are  treated  for  all  varieties  and  stages  of  tuberculous  disease.  This  book 
is  a  development  and  expansion  of  the  original  pamphlet  on  construction,  "Some  Plans 
and  Suggestions  for  Housing  Consumptives,"  published  in  1909  by  the  National  Associa- 
tion for  the  Study  and  Prevention  of  Tuberculosis,  and  includes  the  results  of  studies  made 
on  the  question  of  sites,  in  order  to  determine  in  some  degree  the  effect  of  location  and 
surroundings  from  both  the  clinical  and  economic  points  of  view.  During  the  past 
two  years,  in  a  number  of  states,  legislation  has  been  enacted  authorizing  counties  to 
establish  institutions  for  the  treatment  of  tuberculous  patients.  The  rapid  growth  of  this 
movement  has  brought  about  many  new  problems  in  the  construction  and  maintenance  of 
hospitals  and  sanatoria,  and  it  has  been  the  aim  to  embody  in  this  work  such  material  as 
might  help  in  the  solution  of  these  difficulties. 

Cost  of  Construction 

It  is  the  opinion  of  the  majority  of  those  who  have  had  experience  in  constructing 
and  administering  tuberculosis  hospitals  and  sanatoria,  that  it  is  \nse  to  build  in  a  compara- 
tively inexpensive  manner.  Excellent  results  have  been  obtained  by  the  open-air  method 
of  treating  tuberculous  patients  in  institutions  built  on  simple  and  economical  plans;  and 
further,  this  class  of  institutions  returns  patients  to  their  homes  \\'ithout  making  them  un- 
duly discontented  with  the  environment  and  life  to  which  they  belong.  It  may  therefore 
be  said  that  those  who  adhere  to  simplicity  and  economy  in  sanatorium  construction  and 
furnishing,  and  who  supply  patients  with  good  wholesome  food,  cleanliness,  light  employ- 
ment, and  a  happy,  friendly  atmosphere,  are  operating  along  modern  and  approved  lines. 

One  of  the  first  questions  asked  when  the  establishment  of  either  a  sanatorium  for 
incipient  cases  or  a  hospital  for  advanced  cases  is  proposed  in  a  community,  is,  "What 
funds  will  be  needed  for  constructing  and  maintaining  the  institution?"  In  general  terms 
it  may  be  stated: 

A  Sanatorium  for  Incipient  Cases,  having  a  capacity  of  fifty  patients,  will  cost  to 
build  and  equip  (exclusive  of  the  land)  825,000  and  upward. 

A  Hospital  for  Advanced  Cases,  haNing  a  capacity  of  fifty  patients,  will  cost  to 
build  and  equip  (exclusive  of  land)  850,000  and  upward. 

A  Hospital  for  Both  Classes  of  Cases,  ha\'ing  a  capacity  of  fifty  patients,  will  cost 
to  build  and  equip  (exclusive  of  land)  $35,000  and  upward. 

In  other  words,  it  will  cost  to  build  and  equip  a  complete  institution  for  Incipient 
Cases  about  S500  per  bed;  for  Advanced  Cases  Si, 000  per  bed;  and  for  Both  Classes  of 
Cases  in  the  same  institution  S750  per  bed. 

14 


Introduction 


Cost  of  Administration  Buildings 

Administration  buildings  for  an  institution  housing  fifty  patients  can  be  constructed 
for  $12,000  and  upward,  the  cost  depending  upon  the  material  used  and  the  exterior  and 
interior  finish. 

Cost  of  Infirmaries  and  Pavilions  for  Advanced  Cases 

Infirmaries  and  pa\dlions  for  advanced  cases,  having  a  capacity  of  twenty  patients, 
housed  in  single  rooms,  can  be  constructed  for  $10,000  and  upward. 

Cost  of  Lean-tos 

Lean-tos  ha\dng  a  capacity  of  sixteen  incipient  cases  can  be  constructed  for  $800 
and  upward. 

Examples  of  Appropriations 

The  following  list  is  given  in  order  to  show  how,  in  an  actual  case,  $100,000  was 
expended  for  the  construction  of  a  State  Sanatorium  housing  one  hundred  and  fifty  patients 
of  all  classes  except  the  very  far  advanced  cases. 

Administration  Building $31,500 

Four  Lean-tos  (each  $3,500) 14,000 

Two  Wards  for  Advanced  Cases  (each  $7,000) 14,000 

Power  House  and  Heating  Plant 5,000 

Sewage  Disposal  Plant 2,000 

Water  Pumping  and  Supply  Plant 5,ooo 

Boilers  and  Machinery 3^300 

Furnishings 7,000 

Laundry 1,200 

Land  (Site) 5>5oo 

Expenses  of  Building  Commission ii»5oo 

Total $100,000 

The  following  is  cited  in  order  to  show  the  distribution  of  an  appropriation  for  the 
construction  of  a  County  Hospital  having  a  capacity  for  fifty  patients,  of  all  classes. 

Site,  Water  Supply  and  Sewage  Disposal $10,000 

Administration  Building 16,000 

Ad\anced  Case  Pavilion  (Twenty  Beds) 10,000 

Two  Incipient  Case  Pa\ilions  ($2,500  each) 5,000 

Total $41 ,000 

Arrangement  of  the  Floor  Plans  for  Administration  Buildings 

Many  Administration  Buildings  constructed  for  Tuberculosis  Hospitals  or  Sanatoria 
have  been  designed  on  general  hospital  lines.  This  has  not  pro\-en  to  be  the  most  satis- 
factory type  of  building  for  administrati\-e  purposes,  as  the  medical  stafY,  nurses  and  ser- 
vants are  often  arrested  or  cured  cases  of  tuberculosis.  Administration  buildings  that 
seem  best  adapted  for  institutions  of  this  class,  are  those  constructed  so  that  all  persons 
housed  in  them  may  haA-e,  if  desired,  individual  open-air  sleeping  porches.  For  this  reason, 
it  is  the  opinion  of  many  authorities  that  all  buildings  for  tuberculosis  institutions  should  be 
of  the  open  t\pe;  that  is  to  say,  with  walls  pierced  by  as  many  windows  reaching  from  the 
floors  to  the  ceiling  as  possible,  and  all  apartments  arranged  so  that  they  may  be  thrown 


I 


0 


Introduction 


open  on  at  least  two  sides.  Amusement  halls,  reading,  dining  and  sitting  rooms,  which  are 
constructed  as  small  individual  buildings,  and  arranged  to  be  opened  on  all  sides  when  the 
weather  permits,  arc  being  erected  in  greater  numbers,  and  prove  satisfactory.  Buildings 
used  by  the  administrative  departments,  except  in  cities  or  towns  where  land  is  valuable, 
are  said  to  give  better  service  when  entirely  separated  from  the  patients'  quarters.  Where 
sites  are  large  enough,  one-story  buildings,  even  for  administrative  purposes,  are  becoming 
popular. 

Arrangement  of  Floor  Plans  for  Pavilions  for  Advanced  Cases 

Pavilions  for  advanced  tuberculous  cases  have  also,  in  the  past,  been  constructed  in 
the  same  manner  as  general  hospital  wards,  but  as  it  has  been  found  that  many  advanced 
tuberculous  patients,  with  proper  care,  quickly  improve  under  the  open-air  treatment,  these 
buildings  are  now  being  planned  so  that  open  porch  space  may  be  allotted  to  all  the  inmates, 
and  indi\ddual  rooms  pro\dded  for  all  far  advanced  cases. 

Arrangement  of  Floor  Plans  for  Lean-tos 

The  only  changes  of  importance,  during  the  past  months,  made  in  designing  the 
lean-to  type  of  building,  have  been  in  the  pro\ision  of  larger  lockers  for  each  patient,  and 
in  placing  transverse  partitions  on  the  open  sleeping  porches  in  order  to  house  the  patients 
in  smaller  groups.  It  may  be  said  that  practically  all  new  designs  call  for  lockers  which  are 
large  enough  to  be  used  as  private  dressing  rooms,  and  in  many  instances  fitted  with  a 
chest  of  drawers,  a  mirror,  racks  for  toilet  articles,  and  other  conveniences. 

Transportation 

The  importance  of  keeping  down  the  cost  of  maintaining  an  institution  after  it  is 
erected,  should  be  always  before  those  selecting  the  site  and  planning  the  buildings.  Trans- 
portation expense  is  one  of  the  larger  factors  in  this  problem,  and  it  is  becoming  clearer  that 
public  institutions  must  be  placed  on  or  near  good  transportation  facilities.  In  a  number 
of  instances,  railroad  companies  ha\'e  willingly  put  in  spurs  or  sicUngs  free  of  charge,  as  the 
sites  chosen  were  near  their  right-of-way,  and  it  is  advisable  that  authorities,  considering 
the  establishment  of  a  sanatorium  or  hospital,  consider  this  question  with  care  before  pur- 
chasing an  otherwise  desirable  property. 

T.  S.  C. 


i6 


SECTION  I 
Site  and  Grouping 


SECTION  I 
Site  and  Grouping 


Sanatorium  Sites 

In  selecting  a  site  in  the  open  country  for  a  tuberculosis  sanatorium,  to  house  in- 
cipient and  moderately  advanced  cases,  a  decision  must  be  made  as  to  whether  the  advan- 
tage of  having  the  patients  near  at  hand  and  accessible  to  their  friends  overweighs  the 
possible  benefit  to  be  obtained  by  placing  the  institution  in  a  region  more  favorable  from  a 
climatic  point  of  view,  but  far  from  the  patients'  homes.  It  is  now  generally  agreed  that 
in  the  treatment  of  tuberculosis  excellent  results  can  be  obtained  in  practically  any  section 
of  the  country  and  the  desirability  of  local  institutional  pro\ision  can  be  accepted  as  an 
established  fact.  Within  a  short  distance  of  almost  every  city  and  town,  land  can  be 
obtained  where  tuberculous  patients  will  do  well. 

Transportation  Facilities 

Transportation  facilities  should  always  be  carefully  considered,  as  a  long  haul  from 
the  railroad  or  landing  adds  expense  both  in  building  and  maintenance.  Probably  in  the 
near  future  most  of  the  institutions  founded  with  the  intention  of  housing  over  one  hundred 
patients,  will  be  placed  upon  land  that  can  be  reached  without  great  expense  by  a  private 
branch  or  spur  from  the  nearest  railroad,  or  by  some  other  means  of  public  transportation. 
A  site  on  a  direct  trolley  line  is  very  desirable  in  order  to  make  it  accessible  to  the  patients' 
friends.  It  is  often  hard  to  hold  consumptives  in  a  sanatorium,  for  the  very  sick  do  not 
like  to  leave  their  families,  and  many  incipient  patients  become  restless  when  first  com- 
pelled to  drop  their  regular  occupations.  If  a  sanatorium  is  close  to  the  towns  from  which 
most  of  the  patients  are  drawn  and  where  by  a  short  trolley  trip  visitors  can  reach  it  easily, 
the  location  will  help  very  largely  in  making  the  patients  contented. 

Extent  and  Nature  of  the  Land 

The  site  should  be  a  tract  of  land  from  twenty  to  two  hundred  acres  in  extent  and 
it  will  be  more  valuable  for  its  purpose  if  it  includes  forest,  orchard  and  land  that  can  be 
cultivated.  It  is  now  generally  conceded  that  incipient  patients  improve  faster  when  they 
are  supplied  with  work  under  careful  supervision,  and  at  many  sanatoria,  if  directed  by  an 
efficient  medical  superintendent,  they  will  be  able  to  do  a  considerable  part  of  the  farm  work 
with  real  benefit  to  themselves  and  a  reduction  in  the  cost  of  their  maintenance.  When 
there  is  a  choice  of  a  number  of  sites,  a  damp  or  swampy  location  should  be  avoided,  as  such 
land  when  selected  must  be  drained.  The  expense  of  preparing  some  land  is  \-ery  great, 
while  the  natural  advantages  of  another  property  may  be  such  that  a  large  outlay  for  im- 
provement is  not  necessary.  For  these  reasons  it  is  advisable  to  have  a  thorough  examina- 
tion of  possible  land  made  before  it  is  chosen  as  a  site  for  a  sanatorium. 

i8 


Site  and  Grouping 


Lighting,  Water  and  Sewage 

A  good  supply  of  water  is  a  necessity,  and  for  this  reason  when  building  near  a  city  it 
is  well,  if  possible,  to  secure  property  within  the  line  of  the  city  water  supply  and  sewer 
systems,  thus  settling  the  cjuestion  of  water,  sewage  disposal  and  lights.  On  all  other  land 
considered  there  should  be  good  springs,  a  running  stream  of  clear  water,  or  the  possibility 
of  obtaining  it  by  dri\ang  a  thoroughly  protected  well.  The  disposal  of  sewage  must  also 
be  considered  before  the  land  is  acquired,  as  the  quality  of  the  soil,  the  rise  of  the  land  and 
the  position  of  water  courses  and  lakes  enter  into  the  question  and  increase  or  reduce  the 
cost  of  installation  and  maintenance.  These  subjects  are  all  considered  more  in  detail 
under  the  section  on  administration  buildings. 


^o- 


Meteorological  Conditions 

It  is  very  important  that  the  meteorological  conditions  of  a  prospective  site  should 
be  known.  This  means  obtaining  data  with  regard  to  the  altitude,  average  humidity, 
number  of  stormy  days  in  the  year,  highest  and  lowest  degrees  of  heat  and  cold,  prevailing 
winds  and  any  atmospheric  peculiarities  which  might  affect  either  the  patients  or  building 
materials.  It  is  well  to  remember  that  vastly  dififering  conditions  are  often  found  within 
a  radius  of  a  few  miles;  therefore,  such  information  should  be  gathered  on  the  site  itself. 
Land  where  strong  winds  prevail  during  certain  seasons  of  the  year  and  where  heavy  frosts 
occur  more  frequently  during  the  winters  than  in  other  nearby  localities  should  be  avoided 
if  possible.     Usually  the  southern  exposure  of  a  hill  or  mountain  is  to  be  preferred. 

Natural  Beauty 

The  problem  of  holding  tuberculous  patients  at  sanatoria  grows  more  serious  each 
year,  and  as  the  institutional  care  of  certain  classes  of  cases  seems  to  be  an  absolute  necessity 
in  order  to  control  the  disease,  every  effort  should  be  made  to  place  patients  upon  sites 
that  have  natural  attractions  which  will  help  to  amuse  and  make  them  contented.  The 
open  country,  where  a  sanatorium  for  incipient  cases  is  generally  placed,  usually  offers  a 
choice  of  sites  some  of  which  may  have  great  natural  beauty.  In  making  a  decision  from 
several  pieces  of  property  offered,  this  should  be  considered  as  a  valuable  asset.  A  sloping, 
rolling  or  hilly  piece  of  land  is  more  desirable  than  a  level  one.  Mountains,  hills,  meadows 
and  trees  add  to  the  beauty  of  the  view,  and  a  forest,  lake  or  stream  gives  opportunities  for 
amusement.  A  great  deal  can  Ije  done  by  artificially  improving  the  grounds  where  there 
is  a  lack  of  natural  beauty,  and  in  the  selection  of  a  site  in  a  bare  or  fiat  country  this  should 
be  planned  for. 

Examination  of  Land 

The  following  questions  u.sed  by  the  National  Association  for  the  Study  and  Preven- 
tion of  Tuberculosis  when  asking  for  information  needed  by  its  Bureau  of  Hospital  and 
Sanatorium  Construction,  may  be  of  some  assistance  to  those  e.xamining  a  property  for  the 
purpose  of  determining  its  \alue  as  a  site  for  hospital  and  sanatorium  purposes. 

1.  How  many  acres  of  land  are  available  for  Sanatorium  purposes? 

2.  Is  the  ground  fiat,  rolling,  or  on  a  hillside? 

3.  What  is  the  degree  and  exposure  of  the  slope  of  the  hills? 

4.  Are  there  trees  for  protection  from  prevailing  winds? 

5.  What  is  the  direction  of  the  [prevailing  winds  in  summer?     In  winter? 

6.  What  is  the  altitude  above  sea  le\"el  and  above  surrounding  country? 

7.  What  is  the  amount  of  moisture  precipitation  per  year? 

19 


Section  I 


mf^iJKi^^/ 


^ 


''■■ii 


No.  I. — Loomis  Sana.jrium,  Liberty,  N.  Y.    \'ie\vs  of  a  Farm-house  before  and  after  Remodeling. 

Note  the  Wide  Si'-epinc.  Porches  ConstrVcted  on  the  Front  of  the  Building  in  the  Lower 

Illustration.      See  illuslralions  72.  73,  91  and  108  for  further  description  of  this  institution.) 


20 


Site  and  Grouping 


8.  What  is  the  a\'erage  amount  and  duration  of  snow? 

9.  What  is  the  highest  and  lowest  recorded  temperature? 

10.  What  is  the  mean  temperature  of  the  winter  months? 

11.  What  is  the  mean  temperature  of  the  summer  months? 

12.  Is  it  possible  to  use  the  local  water  supply  of  the  nearest  town? 

13.  At  what  height  on  the  property  above  or  below  the  building  site  is  the  water 

supply? 

14.  What  is  the  amount  of  water  flow  in  gallons  per  minute? 

15.  What  is  the  direction  and  size  of  the  water  courses  on  the  property? 

16.  What  are  the  lighting  facilities  in  the  neighborhood,  gas,  electricity,  etc.? 

17.  What  is  the  composition  of  the  soil? 

18.  What  building  materials  are  available  on  or  near  the  propert}'?     Can  sand, 

building  stone,  rough  stone  for  foundation,  brick,  cement,  lime  and  timber 
be  easily  obtained? 

19.  What  are  the  transportation  facilities,  such  as  railroad,  trolley  lines,  etc.?, 

20.  Where  is  the  principal  approach  to  the  proposed  site? 

21.  What  is  the  distance  from  the  nearest  saw  and  planing  mill? 

22.  Are  there  any  old  buildings  on  the  site?     (Give  full  description  with  a  drawing 

of  the  floor  plans  and  photographs  of  the  front  and  side  elevation.) 
Note:   Sketch-map  of  proposed  property  showing  location  of  buildings,  entrances, 
water-courses,  etc.,  is  very  desirable. 

Farm  Buildings 

Often  farm-houses  or  other  structures  stand  on  the  land  chosen  and  can  be  remodeled 
so  as  to  make  useful  sanatorium  buildings.  The  expense  of  constructing  the  institution  may 
be  materially  reduced  if  these  are  good,  substantial  structures,  but  they  should  be  e.xamined 
carefully  and  unsanitary  conditions  corrected,  especially  if  the  buildings  are  damp  at  any 
season  of  the  year.  Careful  inspection  of  the  plumbing,  drains,  and  cellar  should  always  be 
made  by  an  experienced  sanitarian.  When  the  walls  of  the  cellars  are  damp,  some  method 
should  be  used  to  obtain  a  circulation  of  air  about  the  foundation.  This  can  be  done  by  a 
trench  opened  on  the  outside  of  the  house,  and  a  new  wall  built  beside  the  old  foundation, 
leaving  an  air  space  between  the  two  walls.  The  cellar  floor  should  then  be  relaid  with  a 
foundation  of  broken  stone,  covered  with  cement,  and  openings  made  in  the  cellar  walls  to 
procure  plenty  of  light  and  air.  The  greatest  care  must  be  used  to  prevent  dampness 
around  all  old  buildings;  in  some  places  a  subsoil  system  of  drainage  will  be  needed,  while 
in  others  it  may  be  necessary  to  remove  trees  close  to  the  house. 

In  all  rooms,  where  there  is  sufficient  wall  space,  new  windows  should  be  made,  and 
old  windows  cut  down  to  the  floor  and  up  to  the  ceiling.  \'entilation  for  the  winter  months 
may  be  obtained  by  building  fireplaces  or  installing  \entilating  flues,  and  other  appliances 
used  to  give  a  continuous  change  of  air.  Often  it  will  be  necessary  to  install  baths  and 
toilets  and  have  connections  made  with  the  water  supply  and  sewage  disposal  plants. 

Many  old  farm-houses  are  built  of  heavy  timbers  which  are  usually  well  preserved 
and  can  be  repaired  and  put  in  excellent  condition  without  great  expense.  When  planning 
a  rearrangement  of  an  old  building  for  administration  purposes,  a  large  dining  room  is 
usually  the  most  important  apartment  to  be  provided,  and  often  can  be  made  by  removdng 
the  partitions  between  rooms  on  the  ground  floor  and  throwing  two  or  three  together. 
Many  institutions-  have  been  started  by  housing  the  administrative  department  in  old 
buildings  which  were  only  large  enough  for  a  kitchen,  dining  room  and  office  on  the  first 
floor,  and  a  few  rooms  for  the  staff  on  the  second.  A  small  hospital  star*  ,'d  in  this  way  may 
provide  for  a  large  number  of  patients. 

An  old  country  mansion  will  often  make  a  good  administrati*  ;i  centre  for  a  small, 

21 


Section  1 


iUK-IlS^  :£^: 


No.  2. — The  Natural  Features  of  the  Land  shown  in  These  Views  Greatly  Add  to  the  Value   of 

Property  for  Sanatorium  Sites.     Thk  Group  of  Biildinc.s  in  the  Upper  Illustration 

IS  THE  Harlow  Sanatorium.     (Sec  a  description  of  the  cottages  on  page  159.) 


22 


Site  and  Grouping 


prixate  sanatorium,  in  many  cases  without  remodeling.  Small  cottages  of  the  Millet 
type  (Illustration  96),  or  those  of  the  Open  air  Sanatorium,  Oregon  (Illustration  107),  can 
then  be  built  about  the  grounds  for  a  comparatively  small  outlay. 

The  barns  and  out-buildings  if  in  good  condition  will  also  save  a  considerable  outlay, 
for  they  can  be  used  for  housing  cows,  chickens  and  other  domestic  animals  which  should 
be  counted  on  to  reduce  the  cost  of  maintenance. 

Grouping 

There  is  a  constant  call  for  information  as  to  the  best  methods  of  arranging  buildings 
on  the  sites  for  new  institutions  in  order  that  the  plants  when  completed  can  be  run  without 
undue  waste  of  funds  or  energy.  It  is  to  be  remembered  that  the  economical  operation  of 
a  hospital  or  sanatorium  after  it  is  finished  and  filled  with  patients,  is  of  much  more  im- 
portance than  the  initial  cost  of  construction.  Many  existing  sanatoria  of  large  size  were 
started  in  a  small  way,  additions  being  made  in  a  haphazard  manner  as  necessity  required, 
and  very  little  planning  done  except  for  administration  buildings,  power  houses  and  patients' 
quarters,  before  the  construction  of  the  plant  was  commenced.  It  is  also  a  fact  that  the 
superintendents  of  a  number  of  new  institutions  have  found  after  their  plant  was  supposed 
to  be  ready  for  good  work,  that  large  additions  to  their  buildings  were  necessary  to  reduce 
the  cost  of  maintenance  to  a  defensible  figure.  In  order  to  overcome  this  difficulty  in  the 
future,  for  projected  institutions,  a  general  block  plan  of  the  site  should  be  made  before  con- 
struction is  started.  This  is  particularly  true  for  public  institutions  depending  for  their 
support  upon  the  good  will  of  the  community  which  they  are  to  serve,  as  it  will  greatly  help 
in  producing  a  symmetrical  whole  and  avoid  waste  in  maintaining  the  plant  when  completed. 
In  planning  a  new  hospital  or  sanatorium  the  object  should  be  to  house  the  patients  in  a 
way  that  will  provide  as  much  comfort  as  possible.  The  size  of  the  site  and  the  block  plan 
of  the  grounds  depend  upon  the  number  of  buildings  to  be  erected  and  the  manner  in  which 
the  completed  institution  is  to  be  administered. 

Grounds 

For  a  sanatorium  ha\ing  a  capacity  of  about  one  hundred  patients  situated  in  the 
op^n  country,  a  site  should  consist  of  about  two  hundred  acres  of  land,  to  be  apportioned 
somewhat  in  the  following  manner. 

20  to  40  acres  for  sanatorium  Iniildings,  amusements,  park,  forest  and  lake. 

10  to  20  acres  for  farm  buildings  and  the  care  of  domestic  animals. 

20  to  30  acres  for  a  \-egetable  garden  and  potatoes. 

10  to  20  acres  for  an  orchard  and  small  fruits. 

20  to  _:;o  acres  for  corn  fodder. 

60  tt)  So  acres  for  pasture  or  grain. 

Usually  a  part  of  the  site  must  be  cleared  and  laid  out  as  a  park,  with  walks  and 
dri\es,  while  roads  and  cement  or  gravel  paths  with  water  mains  beside  them  and  lire  plugs 
at  suitable  points  arc  required  near  and  between  the  buildings.  For  such  impnn-ements  on 
the  grounds  from  $2,000  to  S  10.000  should  be  appropriated. 

Railroad  Station 

Where  a  site  is  situated  beside  or  near  a  railroad,  or  an  interurban  trolley  system,  the 
institution  should  have  a  station,  and  in  sparsely  settled  parts  of  the  country  the  transporta- 
tion company  may  be  willing  to  construct  it  for  the  sanatorium.     The  building  may  be  a 

23 


Section  I 

one  story  frame  or  brick  structure  15  feet  wide  by  30  feet  long,  divided  into  one  large  room 
15  by  15  feet,  and  two  small  rooms  yl^  feet  wide  by  15  feet  long,  and  having  at  one  end  a  cov- 
ered freight  shed  10  feet  wide  by  20  feet  long.  When  the  right-of-way  is  near  the  sanatorium 
buildings  the  station  can  be  used  to  house  the  post-office,  telephone  exchange,  express  office 
and  a  store  for  the  convenience  of  the  patients  who  often  wish  to  purchase  material  for 
personal  use. 

It  is  said  to  be  an  advantage  to  a  transportation  company  to  obtain  the  location  of  a 
sanatorium  near  its  right-of-way  and  in  many  sparsely  settled  sections  of  the  country  the 
company  may  be  willing  to  give  the  land  for  the  institution's  site.  The  sanatorium  has  a 
great  educational  value;  it  gives  employment  to  local  people;  it  has  a  pay-roll  of  from 
$1,000  to  $1,500  per  month,  a  part  of  which,  at  least,  is  expended  in  the  neighborhood;  it 
brings  friends  and  visitors  to  nearby  hotels,  benefits  the  merchants,  and  creates  a  market  for 
produce  raised  in  the  vicinity. 

Buildings  and  Improvements  for  Block  Plan 

The  following  is  a  list  of  the  buildings  and  improvements  to  be  considered  by  the 
architect  when  laying  out  the  site. 

Administration  Building. 

Service  Building. 

Patients'  Pavilions. 

Amusement  Pavilion. 

Power  House  (Heating,  Lighting  and  Water-supply). 

Laundry  and  Sterilizing  Room. 

Industrial  Shop. 

Ice-house  or  Cold  Storage. 

Railroad  Station,  Post-office,  and  Telephone  Exchange. 

Carpenter  and  Paint  Shop. 

Store-house,  Scale-house  and  Bakery. 

Green-house. 

Two  hundred  feet  of  Cold  Frames  or  Forcing  Beds. 

Vegetable  Cellar. 

Garage. 

Barn  for  Horses. 

Barn  for  Cows. 

Silo. 

Milk  House. 

Colony  Chicken  Houses.  ' 

Hog  House. 

Sewage  Disposal  Plant. 

Sites  for  Hospitals  to  House  Advanced  Cases 

The  choosing  of  a  site  and  the  grouping  of  the  buildings  of  a  hospital  for  far  advanced 
cases  usually  presents  an  entirely  different  problem  from  that  involved  when  founding  a 
sanatorium  for  incipient  cases.  It  is  usually  desirable  to  provide  for  the  advanced  patient 
in  or  near  the  town  from  which  he  comes,  and  therefore  the  choice  of  a  site  is  largely 
governed  by  the  cost  of  the  land  and  the  attitude  of  the  surrounding  property  owners. 

A  hospital  for  this  purpose  should  not  be  placed  in  a  cjuarter  where  noise,  the  smoke 
from  factories  or  the  dust  from  uncared-for  streets  will  affect  the  patients.  Otherwise, 
almost  any  site  is  suitable  which  can  be  easily  reached,  and  is  large  enough  to  allow  for  the 
construction  of  porches  on  the  builcUngs.  These  cjuestions  are  considered  more  in  detail 
in  Section  III,  Administration  Buildings  and  Patients'  Quarters  Combined. 

24 


Site  and  Grouping 


EXAMPLES  OF  GROUPING  AND  SITES 

The  following  institutions  are  good  examples  of  various  methods  of  grouping  build- 
ings and  laying  out  sites. 

The  Maryland  State  Sanatorium,  Sabillasville,  Md.  (Illustration  3.)  This 
is  a  well  chosen  site  for  a  state  institution,  situated  near  the  top  of  one  of  the  mountains 
of  the  Blue  Ridge  range,  sixty-seven  miles  from  Baltimore  on  the  Western  Maryland 
Railroad.  The  sanatorium  owns  the  station  and  has  placed  its  power  house  on  a  siding 
close  to  the  railroad  in  order  to  run  coal  cars  directly  over  the  storage  bins.  The  building 
site  is  reached  from  the  power  house  and  railroad  station  by  a  well  graded  macadamized 
road  twenty  feet  wide  and  a  quarter  of  a  mile  long,  which  ascends  gradually  through  a 
beautiful  woodland.  The  buildings  have  been  placed  on  a  comparatively  flat  piece  of 
land  lying  on  the  south  side  of  the  mountain,  with  a  beautiful  view  of  the  valley.  Behind 
them  the  ground  rises  for  about  four  hundred  yards,  protecting  the  site  from  the  north 
winds.  At  the  top  of  this  ridge  is  a  concrete  reservoir,  having  a  capacity  of  seventy  thou- 
sand gallons  and  suppHed  with  water  by  pumps  in  the  power  house.  The  buildings  are 
grouped  together  as  shown  in  the  illustration  because  of  the  topographical  features  of  the 
land.  The  Administration  Building  stands  in  front  and  is  connected  by  a  corridor  with 
the  Service  Building  directly  in  its  rear.  The  sleeping  shacks  are  arranged  in  two  rows  on 
both  sides  and  to  the  rear  of  the  main  buildings  and  the  slope  of  the  ground  allows  a  good 
view  of  the  valley  and  mountain  from  their  porches  which  overcomes  the  objection  of 
placing  the  front  of  one  shack  directly  in  the  rear  of  another.  The  capacity  of  the  plant 
is  two  hundred  patients  at  an  estimated  cost  of  $150,000. 

The  Georgia  State  Sanatorium,  Alto,  Ga.  (Illustration  4.)  This  site  is  a  tract 
of  land  comprising  two  hundred  and  fifty-seven  acres,  located  on  the  main  Une  of  the 
Southern  Railway,  two  miles  from  Alto  and  seventy-four  miles  southeast  of  Atlanta,  with 
a  station  about  a  quarter  of  a  mile  from  the  institution.  The  elevation  is  about  sixteen 
hundred  feet  above  sea  level  in  a  part  of  the  country  comparati\ely  free  from  dust  and 
where  the  air  is  said  to  be  pure  and  invigorating  the  year  round.  The  land  has  a  general 
slope  to  the  southeast  and  is  fairly  well  protected  on  the  north  and  west  by  a  rising  hill 
and  forest  growth. 

The  problem  to  be  solved  by  the  architects  in  arranging  the  block  plan  was  to  care 
for  seventy-five  white  patients  at  the  present  time  and  prepare  for  a  future  growth  of  the 
institution  to  three  hundred  and  fifty  or  four  hundred  white  and  colored  charity  cases  of 
both  sexes.  The  plan  illustrated  was  adopted  because  of  certain  peculiarities  in  the 
contour  of  the  land,  which  lies  in  the  form  of  a  horseshoe  made  by  a  flat  with  two  promon- 
tories jutting  out  from  it  on  the  same  level.  Between  the  promontories  is  a  ravine  forming 
the  main  axis  of  the  block  plan.  The  Administration  Building  is  located  on  the  flat,  directly 
at  the  head  of  the  ravine  at  the  north  of  all  the  patients'  quarters,  which  are  arranged 
on  the  two  promontories.  This  plan  worked  out  so  well  that  one  contour  line  runs 
through  seventy-five  per  cent,  of  the  buildings,  adding  greatly  to  ease  of  administra- 
tion, as  a  level  path  will  connect  them.  Practically  everything  on  the  grounds  can  be 
seen  from  the  administration  building,  as  the  other  structures  were  arranged  with  that  idea 
in  \iew. 

Nearest  the  entrance  to  the  west  is  the  Reception  Hospital,  where  all  early  cases  will 
be  housed  for  observation  on  their  arrival.     To  the  left  and  front  of  this  is  the  library. 

^5 


Section  1 


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26 


Site  and  Grouping 


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No.  4.^Georgia  State  Sanatorium,  Alto,  Ga.  Scopes  &  Feustmanx,  and  Walter  \V.  Judell,  Asso- 
ciated Architects.  Bi.oc  k  Plan  Showing  the  Contour  Lines  and  the  Method  of  Grouping 
THE  Lean-tos  on  Two  Promontories  in  Front  of  the  Administration  Building.  Note  the 
Negro  Quarters  on  the  Left  of  the  Illustration  in  the  Foreground.  Cap.vcity  to  be  400 
P.atients.  Estimated  Cost.  8175,000.  (Sec  illustrations  65  and  78  for  further  description  of  this 
institution.) 

To  the  east  or  on  the  ri,^ht  of  the  illustration  is  the  infirmary,  now  in  use  as  a  temporary 
administration  building,  and  still  east  of  this  is  the  dining  room  and  the  service  building. 
In  front  of  these  main  buildings  on  both  slopes  of  the  promontories  are  arranged  the 
shacks  for  white  patients  (with  floor  plans  adopted  from  the  King  type  of  lean-to  at  the 
Loomis  Sanatorium)  twenty-four  in  all,  having  a  capacity  of  ten  patients  each.  Back  of 
the  main  entrance  drive  near  the  road  to  the  station  are  the  stables.  On  the  south  and 
east  of  the  service  building  but  on  a  lower  level  is  the  women's  work-shop,  and  back  of  the 
achrinistration  building  are  two  cottages  for  the  superintendent's  family  and  physicians' 
residence.  Still  further  to  the  rear  and  slightly  to  the  east  are  a  number  of  small  cottages 
to  be  used  as  temporary  quarters  for  the  nurses  or  other  members  of  the  staff.  .\  service 
building  similar  in  plan  to  the  infirmary  for  the  white  jjatients  will  serve  the  negro  cjuarters 
which  are  to  be  practically  the  same  as  those  provided  for  the  white  patients,  but  entirely 
separated  from  them  and  concealed  by  a  thick  growth  of  trees  and  shrubbery.  All  the 
buildings  are  grouped  among  the  pines  on  the  southern  slope  of  one  of  the  hills,  well  pro- 
tected from  the  winds  and  with  a  pleasing  outlook  from  the  porches.  About  fifty  feet 
below  these  buildings  in  a  ra\ine  is  a  stream  fed  by  a  sjiring  alongside  of  which  is  placed 
the  pump  house.  This  is  connected  with  an  elevated  tank  for  the  storage  of  water,  located 
on  the  highest  point  of  the  site  to  the  rear  of  the  stables.  There  is  a  good  supply  of  water, 
large  enough,  by  constructing  a  dam,  to  furnish  power  for  the  institution.  .\  farm  and 
dairy  are  contemplated,  for  which  there  is  ample  land.  This  block  i)lan  is  intended  to 
show  the  institution  as  it  will  be  when  completed,  and  the  estiir.ated  cost,  including  jwwer 
plant,  water  sup{)ly  and  sewage  disposal  for  four  hundred  ]iatients,  was  Si75:00c,  divided 
among  the  different  buildings  as  follows: 


Section  I 


Administration  Building $12,000 

Infirmary 15,000 

Reception  Building 15,000 

Service  Building 15.CC0 

32  shacks  at  Si, 800  each 57,6co 

2  work-shops,  $4,000  each S,cco 


Library $3,000 

Recreation  Building 3,000 

Superintendent's  Cottage 3oOO 

Doctors'  Cottage 3oOO 

Stable 5,000 

Xegro  Infirmary' 15,000 


"Waverly  Hill  Tuberculosis  Sanatorium,  Louisville,  Ky.  (Illustration  5.) 
The  Waverly  Hill  site  includes  one  hundred  and  seventy  acres  of  land,  situated  on  a  range 
of  hills  near  Iroquois  Park  and  overlooking  the  Ohio  River  and  a  magnificent  stretch  of 
country. 

The  buildings  are  erected  on  concrete  foundations  with  walls  of  frame  construction, 
covered  on  the  outside  with  stucco,  treated  in  bright  and  contrasting  colors.  The  roofs 
are  covered  with  red  tile  and  the  whole  makes  an  interesting  block  of  sanatorium  buildings 
grouped  closely  together.  The  administration  building,  which  is  two  stories  high,  stands 
alone  in  the  foreground,  its  side  and  rear  windows  overlooking  the  patients'  quarters. 
The  steep  side  of  a  hill  in  the  rear  of  the  service  building  has  been  used  to  ad\'antage  in 
arranging  its  position  and  the  relation  of  the  power  house  to  the  entire  plant.  The  sana- 
torium conducts  a  farm,  dairy  herd,  and  poultry  in  order  to  give  the  patients  pure,  fresh 
food  and  an  opportunity  for  light  exercise  by  work  in  the  open  air.  The  capacity  of  the 
plant  is  forty  patients  and  the  cost  Sico,cco. 


SE^^^^^i'^' -«--,.  WAVERLY    HILL    TUBERCULOSIS    SANATORIUM 


J  J    GA^^riE"      *BCMT 


'^.iii«^^iir'aaaU;j|S;iiL!li««?8|^-^ 


No.  5.— Waverly  Hill  Sanatorium,  Waverly  Hill,  Ky.  J.  J.  Gaffney.  Architect.  Front  Elevation 
AND  Block  Plan  Showing  Contock  Lines  and  Method  of  Grouping  Buildings  on  the  Edge 
OF  A  Hill  with  a  Steep  Slope  at  the  Rear.  Note  Back  View  of  Plant,  Illustration  No.  18. 
Capacity,  40  Patients.     Estimated  Cost,  $100,000. 

28 


Site  and  Grouping 


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29 


Section  I 

Agnes  Memorial  Sanatorium,  Denver,  Colo.  ( Illustration  6. )  This  institution 
when  first  constructed,  consisted  of  an  administration  building,  two  pa\ilions  and  a  medical 
building.  The  tloor  plans  were  outlined  by  Dr.  G.  Walter  Holden  and  adapted  to  the 
Spanish  style  of  architecture.  The  paxilions  are  two  stories  high  with  porches  around 
the  entire  structures  on  both  tioors.  Every  patient  is  housed  in  a  separate  bedroom 
II  feet  wide  by  i:;  feet  long,  containing  a  radiator,  a  \'entilating  register  and  a  closet 
3  by  5  feet.  These  rooms  open  on  to  a  central  corridor  at  one  end  and  at  the  other  upon 
a  veranda  space  ii  feet  4  inches  wide  by  8  feet  deep.  This  can  be  curtained  off  by  sliding 
curtains,  in  order  to  make  the  space  private  when  desired.  The  roofs  of  the  porches  are 
raised  to  a  height  that  will  allow  sunlight  to  penetrate  into  each  room  at  some  time  during 
the  day.  It  has  a  capacity  for  forty  patients,  and  cost  $250,000,  and  was  equipped  for 
$50,000  additional. 


)->-t'l;'0ii---.-' 


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^oni-PS  WaB-O 


D/n/rfc  //>!/.  i 


£>i,ocK  -PuAn 


^^^S^A^O 


No.  7. — Indiana  State  Hospital,  Rockville,  Ind.     I^rubaker  and  Stern,  .\rchitects.    Bird's-f.ve  View 

AND  Block  Plan.  Showinc;  a  COmpai  t  (iRorp  of  Buildings  Having  a  Capacity  of  ico  Patients. 

Cost,  $137,000.     (See  illustrations  26,  46  and  51  for  further  description  of  this  institution.) 


30 


Site  and  Grouping 


Indiana  State  Tuberculosis  Hospital,  Rockville,  Ind.  (Illustration  7.)  This 
institution  is  a  good  example  of  a  well  chosen  site  and  also  of  a  method  of  grouping  buildings 
closely  together.  The  accompanying  picture  is  a  bird's-eye  perspective  of  the  hospital  and 
a  portion  of  the  grounds.  The  land  cost  the  state  $24,000  (approximately  S50.00  per 
acre).  There  are  five  hundred  and  four  acres  of  rolling,  well-wooded  land  of  which  one 
hundred  and  twenty-five  acres  are  along  the  creek  bottom.  The  site  lies  on  the  east  side 
of  the  Raccoon  Valley  about  three  miles  east  of  Rockville,  on  a  gravel  road  from  Indian- 
apolis. The  hospital  owns  a  free  right-of-way  for  a  railroad  spur,  of  about  one  mile,  to 
connect  the  property  with  the  Central  Indiana  and  the  Vandalia  Railroads,  which  run 
through  the  valley.  There  is  a  station  and  a  siding  within  one  mile  of  the  site  on  both  of 
the  railroads.  The  buildings  are  located  on  high  ground,  sHghtly  back  from  the  edge  of  a 
bluff,  with  a  beautiful  \iew  overlooking  the  valley.  There  is  good,  clean  gravel  and  sand 
for  building  purposes  on  the  bottom  land,  clear  soft  water  in  large  quantities  in  a  creek  at 
the  foot  of  the  bluff,  and  good  steam  coal  which  can  be  delivered  on  the  site  at  $1.60  per 
ton.  The  water  for  the  institution  is  supplied  by  artesian  wells  in  large  quantities  and  is 
of  the  highest  degree  of  purity.  The  plant  has  a  capacity  of  one  hundred  patients  and  cost 
§137,000. 

Portland  Open  Air  Sanatorium,  Portland,  Ore.  (Illustration  8.)  The  site  of 
the  Portland  Open  Air  Sanatorium  consists  of  eleven  acres,  six  miles  south  of  Portland  on 
a  bluff  three  hundred  feet  above  the  river.  It  is  situated  in  a  grove  of  evergreens,  well 
sheltered  from  the  winds,  and  is  arranged  to  house  all  its  patients  in  separate  cottages 
for  one  or  two  persons  each.  These  are  arranged  around  two  courts  in  front  of  the  admin- 
istration building.  This  plan  is  particularly  interesting  to  superintendents  of  institutions 
housing  only  private  cases,  in  a  country  having  a  mild,  dry  climate  where  dressing  and 
bathrooms  do  not  need  to  be  heated. 


lAimilt-'M'-.l.l-'V^ls    AKCHi-yr 


No.  8. — Portland  Open  Air  Sanatorium,  Portland,  Ore.  Whidden  &  Lewis,  Architects.  Block 
Plan  Shuwinc,  Method  of  (.iRoipiNo  Cottaoes  abolt  Open  Courts  and  their  Relation  to 
THE  Administration  Buildings  at  a  Private  Sanatorium.  Cap.vcity,  40  Patients.  Estimated 
Cost,  S6o,ooo.     (See  illustrations  ih  and  107  for  further  description  of  this  institution.) 

31 


Section  1 


VERMONT  iANATOerVM 


PITTiFOCD    \T 


B        MTH 

LAB  i-ABCJfAn-irv 

C      Ct«)LCB 

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C5   COAT  OtltW 

LB    LIVING  CiKi-w 

0     oeuc  octow 

O       urrrcf 

EP    CSTBANCE   POtCM 

P         PaTitNT 

e  C  EXAMINATION  BOOM 

Pan   psnTPi 

M      mclPJ  0IN.-JCGOOM 

3P      5Ltt.P"s(C  wjo. 

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•-11     LIOBAOv 

T       Tun  C  P'o^i 

■..-t7y:>;f.7Tr, 


WOWErrt   COTIACE 


No.  Q.-Vermont  State  Sanatorium,  Pittsford,  Vt.     Scopes  &  Feustmann.  Architects^^    View  of 

Front  Elevation  and  Block  Plan,  Showing  Method  of  Groupin-c;  Pavilions  in  Front,  and 

AT  THE  Sides  of  the  Administration  Building.     Cap.\city,  40  Patients.     Cost,  $75.ooo- 


Vermont  State  Sanatorium,  Pittsford,  Vt.  (Illustration  q.)  The  buildmg  site 
is  located  on  a  practically  flat  piece  of  land  with  mountains  on  all  sides  and  protected  on 
the  north  by  a  hea\y  growth  of  evergreen  timber.  About  three  hundred  feet  to  the  south 
of  the  institution  is  a  sharp  drop  in  the  land  of  over  one  hundred  feet,  making  a  ravine  in 
which  there  is  a  beautiful  brook.  The  soil  is  a  mixture  of  sand  and  gravel  in  which  the 
infiltration  of  moisture  is  very  rapid,  and  the  water  supply  is  ])rocured  from  the  Pittsford 
waterworks.  The  patients  are  housed  in  individual  rooms  and  the  porches  are  constructed 
under  the  main  roofs  of  the  building  rather  than  in  the  usual  method.  The  administration 
building  is  planned  willi  the  infirmary  in  the  second  story  and  for  an  administrative 
capacitv  of  from  seventy-five  to  eighty  patients.     The  medical  offices  are  placed  m  the 


Site  and  Grouping 


west  wing  and  as  far  from  the  service  wing  as  possible,  in  order  to  avoid  the  noise  from 
the  kitchen.  The  cottages  are  designed  with  a  capacity  for  twelve  patients  each,  six 
patients  on  a  floor,  and  are  connected  with  the  administration  building  by  covered  ways 
which  are  used  by  the  staff  in  inclement  weather  and  as  extra  sitting-out  space  for  the 
patients.  The  present  capacity  of  the  plant  is  forty  patients  and  it  cost  approximately 
$75,000. 

Essex  County  Tuberculosis  Hospital,  Soho,  N.J.  (Illustration  10.  j  This  group 
of  buildings  is  unusual,  as  the  administration  building  is  placed  in  the  rear  of  the  patients 
quarters,  and  all  are  on  the  top  of  a  small  knoll  with  the  land  sloping  rather  abruptly  away 
in  every  direction.  The  three  buildings  are  connected  by  a  covered  passageway  and  the 
pavilions  have  porches  on  the  north  as  well  as  on  the  south  side  of  the  wards.  This  group 
of  buildings  was  constructed  as  a  part  of  the  County  Isolation  Hospital,  and  is  heated  and 
lighted  from  the  central  power-house,  which  is  on  the  same  site.  The  pavilions  are  placed 
on  brick  piers  and  the  administration  building  on  a  brick  foundation,  all  constructed  of 


MK^-^    HAWII.IIIM 


No.  10. — Essex  County  Tuberculosis  Hospital  for  Advanced  Cases,  Soho,  N.  J.  Hurd  &  Sittox, 
Architects.  View  of  Buildings  from  the  Rear  .^nd  One  Side,  .and  Block  Plan  Showing 
Method  of  Grouping  Buildings  ox  a  Knoll  and  Coxxecting  Them  by  a  Covered  P.\ssage\vay. 
Capacity,  84  Patiexts.     Estimated  Cost,  875,000. 

3  3>3 


Section  T 


No.  II. — Maine  State  Sanatorium,  Hebron,  Me.  T.  C.  Stevens  and  J.  H.  Stevens,  Architects. 
View  and  Block  Plan  Showing  Method  of  Grouping  Pavilions  in  the  Rear  of  the 
Administration  Building  and  Power  House.  Capacity,  ioo  Patients.  Estimated  Cost, 
$150,000.     (See  illustrations  23  and  58  for  further  description  of  this  institution.) 

frame  and  covered  externally  with  shingles.     The  capacity  is  for  eighty-four  advanced 
cases  at  an  estimated  cost  of  $75,000. 


Maine  State  Sanatorium,  Hebron,  Me.  (Illustration  11.)  This  institution  is 
situated  in  the  foot-hills  of  the  White  Mountains  two  miles  from  the  Portland  and  Rumford 
Falls  Railroad,  in  a  very  beautiful  country,  well  known  for  the  dryness  of  the  atmosphere. 
The  site  is  near  the  centre  of  the  population  of  the  state  and  consists  of  three  hundred  and 
twenty  acres,  of  which  one  hundred  and  twenty-five  acres  are  farm  land  and  one  hundred  and 
thirty-five  acres  forest  land.  The  buildings  are  well  sheltered  by  a  wooded  mountain 
with  a  fine  open  view  to  the  south.  There  are  many  natural  features,  such  as  forest  land 
and  logging  camps  with  opportunities  for  winter  sports,  which  interest  the  patients  and  are 
an  important  consideration  in  holding  them.  The  water  supply  comes  from  springs  and 
is  stored  in  a  reservoir,  with  a  capacity  of  forty  thousand  gallons,  by  a  pumping  station 

34 


Site  and  Grouping 


equipped  with  electric  pumps.  The  soil  is  a  loam  with  a  subsoil  of  gravel,  having  an 
excellent  drainage,  and  great  fertility.  Beside  the  administration  building  and  pavilions, 
there  is  a  power  house,  a  cow-barn  lighted  by  electricity  and  supplied  with  running  water, 
having  a  capacity  for  twenty-five  cows,  a  milk-house  thoroughly  equipped,  heated  by 


.-S^l-^ 


]f^-^- 


fl- 


i'^^:m^ 


•  w^i;c*t  .Mv 


No.  12.— Preventorium  for  Children,  Farmingdale,  N.  J.  Scopes  &  Felstmaxn.  and  Walter 
W.  Judeli.,  Associated  Architects.  Birds-eye  View  .-vxd  Block  Plan  Showing  Method 
OF  Groupixg  the  BriLDixcs.  (Sec  illustrations  ig.  27  and  95  for  further  description  of  this 
institution.) 


35 


Section  I 

steam  and  supplied  with  li^l^t-  ^i^d  power,  for  Uie  proper  handling  of  milk  and  cream,  a 
large  silo  with  a  capacity  of  fifteen  acres  of  corn,  a  stable  for  ten  horses  and  storage  for 
one  hundred  and  tifly  tons  of  hay.  The  capacity  of  the  plant  is  one  hundred  patients 
and  it  cost  $150,000. 

The  Preventorium  for  Children,  Farmingdale,  N.  J.  (Illustration  12.)  The 
site  consists  at  present  of  about  one  hundred  and  fifty  acres  of  land  and  is  situated  in  a 
rolling  country.  The  buildings  are  placed  on  a  knoll  seventy  feet  above  the  surrounding 
land,  which  has  a  gentle  slope  to  the  south,  and  a  growth  of  timber  on  the  north,  givifig 
good  protection  from  the  winter  winds.  It  is  within  six  or  seven  m.iles  of  Lakewood,  N.  J., 
well  known  for  its  dry  cUmate  and  sandy  soil.  The  entrance  is  about  four  hundred  feet  to 
the  west  of  the  country  road  and  all  the  buildings  are  grouped  about  sixty  feet  apart.  The 
dormitories  containing  the  infirmaries  are  placed  nearest  to  the  administration  building, 
described  on  page  145.  There  is  a  good  sized  creek  within  one  thousand  feet  of  the 
buildings  and  a  small  ri\-er  one-half  mile  from  the  site.  The  Central  Railroad  of  New 
Jersey  crosses  a  corner  of  the  property  and  the  railroad  company  has  put  in  a  siding  one- 
fourth  mile  from  the  power  house  without  cost  to  the  institution. 

The  water  is  supplied  from  an  artesian  well  four  hundred  and  fifty  feet  deep,  which 
was  driven  at  a  point  about  seven  hundred  feet  from  the  buildings,  on  lower  land,  and  is 
covered  by  a  small  pump  house  in  which  is  installed  an  electric  pump  driven  by  power 
generated  in  the  central  power  house  described  on  page  47.  The  water  rises  to  within 
twelve  feet  of  the  surface  and  is  conveyed  to  a  wooden  tank  on  a  tower  seventy-fi\-e  feet 
high. 

This  institution\vas  founded  for  the  purpose  of  preventing  children  from  becoming 
infected  with  tuberculosis  who  live  in  overcrowded  parts  of  New  York  City  and  have 
parents  who  are  tuberculous.  They  are  sent  from  various  clinics  to  the  Preventorium 
where  the  sickly  children,  through  wise  supervision,  open-air  life  and  pure,  good  food,  are 
usually  completely  restored  to  health  in  three  or  four  months.  Only  those  children  be- 
tween the  ages  of  six  and  fourteen  who  are  surrounded  by  tuberculous  individuals  and  are 
without  active  tuberculous  disease  can  be  admitted  to  the  institution.  The  buildings 
shown  have  a  capacity  for  one  hundred  and  twenty-eight  children,  and  cost,  including 
water  supply  and  sewage  disposal,  Si  10,000. 


36 


SECTION  II 
Administration  Buildings 


SECTION  II 
Administration  Buildings 


Methods  of  Sanatorium  Administration 

A  sanatorium  consists  of  two  distinct  parts,  one  for  housing  the  patients  and  the 
other  for  administrative  purposes.  Therefore,  some  kind  of  a  building,  or  a  portion  of  one 
at  least,  is  necessary  for  the  use  of  those  who  have  charge  of  the  institution.  There  are 
three  general  plans  of  administering  sanatoria  for  tuberculous  patients. 

The  first  method  is  to  provide  for  this  use  a  certain  number  of  apartments  in  the 
same  building  that  houses  the  patients. 

The  second  method  (usually  adopted  at  the  present  time)  is  to  pro\-ide  a  separate 
administration  building  and  group  lean-tos  or  cottages  about  it  for  accommodating  the 
patients. 

The  third  method  (used  only  by  large  institutions  of  more  than  one  hundred  and 
fifty  patients  and  occupying  a  wide  acreage)  is  to  provide  a  general  administration  building 
near  the  centre  of  the  site  and  divide  the  patients'  quarters  into  two  or  more  units,  each 
grouped  about  a  small  service  building  containing  a  kitchen,  dining-room  and  other  apart- 
ments needed,  and  placed  at  various  convenient  positions  on  the  site. 

Planning  Administration  Buildings 

In  planning  a  sanatorium  a  good  method  to  follow  is  to  decide  upon  the  number  and 
character  of  buildings  needed  for  administration  and  maintenance,  then  have  these  struc- 
tures designed  and  constructed  of  substantial  material  on  lines  that  can  be  enlarged  when 
necessary.  In  arranging  floor  plans  for  the  administration  building  and  its  auxiliary 
structures  it  should  be  noted  that  the  housing  of  the  administrative  department  practically 
includes  all  buildings  on  the  site,  with  the  exception  of  the  patients'  quarters.  To  house 
this  department  con^'eniently  and  in  such  a  manner  as  will  later  tend  to  economical  opera- 
tion, the  following  questions  should  be  decided  if  possible  before  the  working  drawings  are 
begun. 


"O^ 


1.  The  number  of  patients  to  be  housed  in  the  institution. 

2.  The  stage  of  the  disease  to  be  treated. 

3.  The  class  in  society  from  which  the  majority  of  patients  will  come. 

4.  The  number  of  the  staft'  and  the  method  in  which  they  shall  be  housed. 

5.  The  number  of  servants  and  the  method  in  which  they  shall  be  housed. 

6.  Shall  the  administrative  offices  and  ser\'ice  dei)artment  be  housed  under  one 

roof  or  in  two  separate  structures? 

7.  Shall  an  amusement  pavilion  be  constructed,  or  a  large  room  for  recreation 

purposes  be  provided,  in  the  administration  building? 

8.  Shall  an  industrial  shop  be  built  for  amusement  and  educational  purposes? 

38 


Administration  Buildings 


g.  What  method  of  water  supply  and  storage  shall  be  used? 

10.  What  method  of  heating  shall  be  used? 

11.  What  method  of  lighting  shall  be  used? 

12.  Will  power  be  needed? 

13.  Shall  a  power  house  be  constructed? 

14.  Shall  a  laundry  and  sterilizing  room  be  housed  in  a  separate  building,  the  power 

house,  or  in  the  administration  building? 

15.  Shall  a  vacuum  cleaning  plant  be  installed? 

16.  Can  natural  ice  be  used  and  an  ice  house  be  constructed  or  will  a  cold  storage 

plant  be  needed? 

17.  Shall  the  post-office,  telephone  exchange  and  store  be  housed  in  a  separate  struc- 

ture or  a  room  provided  for  these  in  the  administration  building? 

18.  Shall  a  carpenter  and  paint  shop  be  constructed  or  housed  in  the  basement  of 

the  administration  building? 

19.  Shall  a  central  store-house  with  platform  scale  and  a  bakery  be  constructed,  or 

the  basements  of  the  various  buildings  used  for  storage  and  other  purposes? 

20.  Shall  the  institution  provide  its  own  vegetables  and  construct  a  greenhouse, 

forcing  beds  and  a  root  cellar  ? 

21.  Shall  the  institution  conduct  a  farm  and  supply  its  own  milk,  eggs  and  dairy 

products? 

22.  Will  a  sewage  disposal  plant  be  needed? 

Number  and  Class  of  Patients 

The  answers  to  the  first  three  questions  in  this  list  will  largely  govern  the  solving  of 
all  the  other  problems.  Therefore,  the  descriptions  and  estimates  given  here  were  obtained 
from  public  institutions  having  a  capacity  of  about  one  hundred  patients  in  various  stages 
of  the  disease  and  coming  from  all  classes  of  society. 

Staff  and  Servants'  Housing 

The  following  list  is  given  in  order  to  assist  in  planning  a  sanitary  method  of  housing 
the  staff  and  servants  at  projected  institutions.  The  salaries  paid  at  the  sanatorium  from 
which  this  list  was  obtained  are  low  because  many  convalescent  patients  apply  for  positions 
and  are  ready  to  accept  smaller  salaries  than  are  usually  paid  for  the  same  service  in  other 
institutions,  in  order  that  they  may  remain  in  surroundings  which  will  tend  to  improve 
their  physical  condition. 

Staff  and  Servants  and  their  Salaries 

Superintendent  (Physician) 82,500.00  per  annum. 

Assistant  Superintendent  (Physician) 1,200.00 

Laboratory  Director  (Physician) 600.00 

Business  Manager 1,200.00 

Bookkeeper  and  Clerk 300.00 

Stenographer 360.00 

Matron 480.00 

Superintendent  of  Nurses'  Training  School 900.00 

Dietician 900.00 

Ten  Nurses  (each  $180.00) i,Soo.oo 

Three  Orderlies  (each  S300.00) 900.00 

Postmaster  and  Storekeeper 120.00 

Chief  Cook 960.00 

Two  Cook's  Assistants  (each  $240.00) 480.00 


Carried  forward $12,700.00 

39 


Section  II 


Brought  forward $i 

Chief  Baker 

Baker's  Assistant 

Dish  Washer 

Dish  Washer's  Assistant 

Four  Waitresses  (each  $216.00) 

Six  Maids  (each  $216.00) 

Chief  Engineer 

Engineer's  Assistant 

Fireman 

Carpenter  and  Painter 

Gardener,  in  charge  of  Greenhouse  and  Grounds  .  ,  . 

Two  Garden  Helpers  (each  $360.00) 

Poultry  Man 

Three  Farm  Hands  (each  S360.00) 


2,700.00  per 

720.00 

240.00 

300.00 

216.00 

864.00 
1,296.00 

goo. 00 

4S0.00 

360.00 

600.00 

720.00 

720.00 

600.00 
1,080.00 


annum. 

ii 
l( 

u 
(f 
ii 
ii 
ii 
u 
ii 
ii 
a 


Total 

Note:  This  makes  a  pay-roll  of  $1816.00  per  month. 


.$21,796.00     " 


As  has  been  said  a  large  proportion  of  the  staff  and  servants  may  be  incipient,  con- 
valescent or  cured  tuberculous  patients  and  while  the  employment  of  this  class  will  materi- 
ally reduce  the  size  of  the  pay-roll  it  will  also  call  for  careful  hygienic  and  sanitary  housing 
with  provisions  for  outdoor  sleeping. 

The  upper  stories  of  the  administration  building  when  pro^'ided  with  porches,  are 
used  in  many  institutions  for  this  purpose,  although  the  construction  of  a  staff  cottage,  a 
nurses'  home,  and  a  servants'  pavilion  is  a  better  method  of  housing  them. 


No.  13.— Adirondack  Cottage  Sanitarium,  Saranac  Lake,  N.  Y.     The  Amusement  Paviliox. 

\'iEws  OF  the  Exterior  and  Interior  with  Floor  Plan  and  Cross  Section.     (See 

illustrations  63,  gS,  104  and  109  for  further  description  of  this  institution.) 


40 


Administration  Buildings 


No.  14. — Municipal  Sanatorium,  Otisville,  N.  Y.  Designed  by  Dr.  Hermann  ;m.  Biggs.  J.ames  D. 
Burt,  Architec  t.  Servants'  Building  Xo.  107.  This  Structure  is  .\n  Example  of  a  Le.an-to 
Constructed  with  Fire-proof  M.aterial,  Designed  to  Sl'pply  Open-air  Sleeping  Quarters 
FOR  Servants  who  wish  to  Remain  and  Support  Themselves  .at  the  Institution  after 
Completing  the  Tre.atment.     Capacity,  16  Persons;  Cost,  ^5,000. 


Municipal  Sanatorium,  Otisville,  N.  Y.  The  Servants'  Building.  (Illustra- 
tion 14.)  This  is  a  two-story  building,  with  a  foundation  of  native  stone.  The  walls  are 
of  eight-inch  hollow  terra  cotta  tile,  burned  hard,  and  plastered  on  both  sides.  The  copings 
on  the  parapet  walls  are  of  cast  concrete,  moulded  on  both  edges,  and  reinforced  with  waste 
wire.  The  outside  is  finished  with  wood  float  in  sand,  and  coated  with  a  water-proof  paint. 
The  inside  is  finished  with  plaster  and  painted  with  ordinary  white  lead  and  linseed  oil. 

Each  person  has  an  individual  dressing  room,  about  five  feet  square,  made  with 
low  partitions  in  order  to  allow  a  free  circulation  of  air,  and  furnished  with  a  chair,  table, 
mirror,  shelf,  and  hooks  for  clothing.  The  sleeping  porches  are  divided  by  low,  transverse 
partitions  running  from  the  rear  wall  part  way  across  the  floor.  This  practically  makes  of 
the  porches  small  rooms,  sufficiently  deep  to  allow  space  for  an  easy  chair  inside  the  open 
front.  Both  stories  are  alike  and  the  porch  floors  have  a  pitch  of  three  inches  in  order 
to  drain  storm  and  wash  water  to  an  outlet.  There  is  a  slop  sink  on  each  floor,  an  iron 
fire  escape  on  the  walls  of  both  wings,  and  an  attic  covering  the  centre  of  the  building. 
The  basement  contains  a  heating  apparatus,  two  toilets,  and  baths. 

The  building  accommodates  sixteen  persons,  and  cost  exclusive  of  plumbing  and 
heating,  about  $5,000. 

41 


Section  II 


Service  Buildings 

There  is  a  growing  feeling  among  the  superintendents  of  many  sanatoria  that  the 
best  method  of  housing  the  dining  room  and  kitchen,  is  to  construct  a  separate  service 
building.  The  principal  advantage  of  this  method  of  construction  is  in  isolating  from  other 
departments  the  preparation  of  food,  and  in  giving  greater  opportunity  to  build  an  oj^en 
air  dining  room.  It  is  also  a  much  more  economical  way  of  building  if  an  institution  is  to 
be  started  in  a  small  way  on  lines  which  can  be  enlarged  as  it  grows,  for  it  is  an  easy  matter 
to  enlarge  an  administration  building  by  constructing  a  service  building  nearby.  For 
these  reasons  a  number  of  large  and  small  service  buildings  are  described  and  illustrated  in 
this  section. 

Amusement  Pavilion 

If  good  results  are  to  be  expected  from  the  open  air  treatment  of  tuberculosis,  the 
question  of  making  the  patients  contented  must  be  considered.  Worry  and  depression  are 
large  factors  in  disease  and  anything  that  helps  to  do  away  with  them  is  a  part  of  the  cure. 
Certain  classes  of  patients  often  sit  about  a  hospital  or  sanatorium  day  after  day,  brooding 
over  their  troubles  and  discussing  among  themselves  their  physical  condition,  which  often 
retards  recovery.  If  such  patients  are  kept  interested  in  other  things  they  will  have  less 
time  to  think  about  themselves,  and,  therefore,  amusements  and  interesting  occupations 
should  be  provided.  When  possible,  a  separate  amusement  pavilion  should  be  constructed. 
A  recreation  room  placed  in  the  administration  building  is  not  satisfactory,  as  it  is  very 
hard  to  ventilate,  and  patients  taking  the  open  air  treatment  are  often  oppressed  by  re- 
maining indoors,  and  refuse  to  use  such  rooms.  A  separate  structure  for  an  institution  of 
one  hundred  patients  should  be  about  seventy-five  feet  long  by  thirty  feet  wide,  with  a 
peaked  roof.  The  building  can  be  constructed  of  tile,  brick,  concrete  or  frame  and  the 
roof  supported  by  trusses  and  covered  with  shingles  or  some  patent  roofing  material.  The 
main  room  should  be  open  to  the  roof  about  twenty-three  feet  from  the  floor  to  the  peak. 


No.  15.     Example  of  a  Dining  Room  in  a  Separate  Structure  Which  can  be  Opened  on  All 

Sides. 

42 


Administration  Buildings 


No.  i6.— Portland  Open  Air  Sanatorium,  Portland,  Ore.     \ie\v  of  the  Interior  of  the  Amusement 
Pavilion.     (See  illustrations  8  and  107  for  further  description  of  this  institution.) 


A  stage  can  be  placed  at  one  end  of  this  room,  twelve  feet  deep  by  fifteen  feet  wide,  with  a 
small  room  on  either  side  for  dressing  and  other  purposes.  The  building  in  northern  cli- 
mates must  be  heated,  either  from  the  central  power  house  or  by  a  small  heating  plant 
placed  in  a  cellar  under  the  main  floor.  Both  sides  and  the  end  opposite  the  stage,  except 
for  the  supporting  columns,  should  be  entirely  constructed  of  adjustable  windows  or  doors, 
so  that  the  side  of  the  builcUng  exposed  to  a  wind  or  storm  can  be  closed  and  the  opposite 
side  remain  open.     There  should  also  be  large  ventilators  in  the  peak  of  the  roof  and  on  the 


sides  and  ends  of  the  building. 


(See  Illustrations  Nos.  13  and  16.) 


Industrial  Building 

The  same  argunients  which  are  used  in  advising  a  separate  structure  for  an  amuse- 
ment pavilion,  hold  good  in  regard  to  an  industrial  shop.  This  building  can  be  constructed 
along  the  same  general  lines  and  of  the  same  material  as  the  amusement  pavilion,  the  dimen- 
sions being  about  fifty  feet  long  by  thirty  feet  wide,  one  and  one-half  stories  high,  and  with 
both  sides  enclosed  by  glass  doors  or  windows  that  can  be  entirely  open  when  the  weather 
permits.  It  should  also  be  heated  by  connection  with  the  general  heating  SN^stem  or  by  a 
separate  plant  of  its  own  and  equipped  with  tools  used  in  various  industries,  such  as  light 
carpentering,  cabinet  making,  taxidermy,  art  work  and  photography.  If  the  building  is 
di\-ided  into  a  number  of  rooms,  porches  should  be  added  so  that  the  patients  can  work  out 
of  doors  in  good  weather.  In  every  institution  there  are  always  patients  who  will  be  greatly 
benefited  by  attending  school  and  are  glad  of  an  opportunity  to  do  so.  As  there  is  often  a 
school  teacher  among  the  patients,  who  is  willing  to  teach,  space  f(ir  a  school-room,  if 
needed,  should  be  provided  for  in  this  building. 

Part  of  the  outfit  can  l)e  a  machine  for  stamping  out  sputum  cups,  for  if  suitable 
paper  is  supplied  for  this  purpose,  all  the  cups  used  at  the  sanatorium  can  be  made  by  the 
patients. 

The  cost  of  such  a  building  and  equipment  is  about  84,000,  but  it  may  be  advisable 
to  start  in  a  more  modest  way  in  order  to  test  the  interest  of  the  patients  in  various 
occupations. 

43 


Section  II 


iz^ixCly^'&^-iJ' 


No.    17. — Catawba    Sanatorium,    Catawba,    Va. 

Ax  Example  of  a  Goud  Method  of  Storing 
Water  Where  Streams  can  be  Protected 
FROM  Contamination.  (See  illustrations  30,  69, 
and  80  for  further  description  of  this  institu- 
tion.) 


Water  Supply 

Where  there  can  ])c  no  connection 
with  city  or  other  pubHc  water  mains,  the 
water  supply  for  an  institution  may  be  ob- 
tained in  a  number  of  ways  and  all  available 
sources  should  be  carefully  studied.  There 
may  be  sources  which  can  be  examined  with- 
out great  expense,  such  as  old  wells,  springs, 
brooks,  rivers,  ponds  and  lakes,  or  sources 
which  can  only  be  accurately  determined  by 
experiments  which  are  often  quite  costly, 
such  as  the  driving  of  various  kinds  of  wells 
and  the  building  of  dams  for  the  collection 
of  surface  or  other  intermittent  supplies  of 
water. 

Wells  are  often  the  only  means  by 
which  water  can  be  obtained,  but  shallow 
or  dug  wells  should  not  be  used,  as  the  dan- 
ger of  contamination  is  very  great.  Driven  or  bored  wells  carried  deep  enough,  usually 
three  hundred  or  more  feet,  to  avoid  surface  water,  should  always  be  sunk  for  institu- 
tional use  and  the  site  carefully  selected  with  the  \iew  of  preventing  contamination  of  the 
water  when  it  reaches  the  surface.  Often  w^here  from  thirty  to  fifty  thousand  gallons  per 
day  are  needed  more  than  one  well  must  be  driven  in  order  to  produce  a  sufficient  supply. 
The  cost  of  driving  varies  from  S3. 00  to  $8.00  per  foot,  according  to  the  size  of  the  bore 
and  the  depth  to  which  the  well  is  carried. 

In  making  investigations  of  a  water  supply,  great  care  should  be  used  to  obtain 
information  in  regard  to  the  chances  of  contamination  of  the  source  of  the  water,  the 
chemical  elements  held  in  solution,  and  the  amount  of  the  flow  at  all  seasons  of  the  year. 
In  order  to  decide  whether  a  given  source  will  supply  the  demand,  an  estimate  of  the  daily 
consumption  of  the  proposed  institution  should  be  computed.  Although  it  is  a  very  inaccu- 
rate method,  this  is  usually  done  on  the  theory  that  there  will  be  consumed  in  every  twenty- 
four  hours  by  each  individual  housed  on  the  site,  about  one  hundred  gallons,  by  each  horse 
or  cow  fifty  gallons  and  for  every  acre  of  lawn,  streets,  paths,  or  garden  five  hundred  gallons, 
and  the  estimate  is  intended  to  cover  all  water  used  for  drinking,  cooking,  toilet,  sprinkling 
and  other  necessities. 

A  careful  inciuiry  has  shown  that  institutions  of  one  hundred  patients  having  large 
sites  with  staff,  servants  and  animals,  and  carrying  on  a  farm  will  use  from  twenty 
to  fifty  thousand  gallons  of  water  per  day  and  should  when  possible  have  in  reserve  for 
emergencies,  an  amount  at  least  equal  to  the  daily  consumption.  The  amount  which 
should  be  stored,  depends  upon  the  nature  of  the  site,  which  largely  go\erns  the  expense  of 
constructing  reservoirs.  For  this  reason  from  fifty  to  two  hundred  thousand  gallons  is 
about  the  limit  where  the  cost  is  great,  but  where  natural  basins  can  be  used  by  erecting 
a  small  dam,  larger  quantities  can  be  held  for  a  small  outlay.  The  storage  of  water  in  a  re- 
inforced concrete  reservoir  is  the  most  satisfactory  if  there  is  a  natural  ele\'ation  near  the 
buildings. 

Reservoirs  can  usually  be  placed  in  the  most  convenient  position  available  with- 
out fear  of  obtaining  too  great  a  pressure  in  the  mains,  as  the  force  produced  by  water 
brought  from  a  height  is  greatly  reduced  by  the  friction  in  the  l>ipes.     Where  there  are  no 

44 


Administration  Buildings 


natural  elevations,  water  can  be  distributed  through  an  institution  and  a  moderate  amount 
stored  by  tanks  on  towers,  or  in  the  top  of  the  buildings.  Also  by  stand  pipes,  largely  used 
by  small  towns  in  the  middle  west,  which  give  good  service  and  can  be  adopted  for  the 
larger  institutions,  and  the  various  systems  of  water  supply  using  a  pressure  tank  for  small 
sanatoria. 

Light,  Heat  and  Power 

The  problem  of  lighting,  heating,  and  the  installation  of  power  for  an  institution 
depends  largely  upon  its  situation.  Generally  the  furnishing  of  light  for  hospitals  for 
advanced  cases  situated  in  cities  and  their  suburbs  is  not  a  difficult  matter,  as  the 
trunk  line  of  the  city  electric  lighting  system  or  the  mains  for  illuminating  gas  are 
usually  not  far  distant. 

The  lighting  of  sanatoria  in  isolated  country  districts  is  more  complicated  and  a  choice 
lies  between  the  use  of  kerosene  oil  lamps,  one  of  the  various  processes  for  generating 
illuminating  gas  by  individual  gas  machines  from  oil,  gasolene  or  acetylene,  or  electricity 
produced  by  a  privately  owned  plant.  At  the  present  time  electricity  is  generally  used,  and 
when  installed  in  an  institution  having  a  capacity  of  one  hundred  patients  housed  in  various 
structures,  it  is  estimated  that  about  five  hundred  and  fifty,  sixteen  candle  power  and  one 
hundred  and  fifty,  two  or  four  candle  power  lamps  for  the  buildings,  six  one  hundred 
candle  power  arc  lights  for  the  grounds,  two  six  thousand  candle  power  generators  and  two 
fifty  horse  power  engines  will  be  needed,  the  lamps  being  apportioned  as  follows: 

Administration  Building 154  lights 

Two  Advanced  Case  Pa\'ilions 150      " 

Three  Incipient  Case  Pa\'ilions 183 

Nurses'  Quarters 66 


u 


il 


n 


Amusement  Pavilion 50 

Laundry 15 

Power  House 15      " 

Tunnel 20 

Grounds 6  arc  lights 

Four  candle  power  lights  can  be  used  to  good  ad\'antage  in  many  places,  such  as 
hall-ways,  closets,  toilets  and  porches,  and  are  a  great  saving,  as  every  candle  power  need- 
lessly used  in  the  course  of  a  year  means  a  waste  of  fuel. 

In  heating  sanatorium  buildings  practically  every  method  has  been  tried  and  can 
still  be  found  giving  fairly  good  service  at  one  or  another  of  the  various  institutions.  These 
in  a  general  way  are  steam  and  hot  water  plants,  hot  air  furnaces,  stoves,  fire-places  and 
gas  fixtures.  Here  again  the  location  and  climate  are  largely  the  determining  factors  in 
making  a  choice  of  a  method  of  heating,  particularly  where  the  buildings  of  an  institution 
are  heated  as  separate  units. 

Power  can  be  used  for  lighting,  pumping,  vacuum  cleaning,  drixing  laundry  ma- 
chinery, a  cold  storage  plant,  elevators,  .v-ray  apparatus,  laboratory  instruments,  lathes, 
circular  saws  and  other  machinery  in  carpenter  and  repair  shops. 

Power  House 

In  discussing  the  needs  for  light,  heat  and  power,  and  the  methods  to  be  employed 
in  producing  them,  it  should  be  remembered  that  it  is  possible  where  a  central  plant  is  to 

45 


Section  IT 


No.  i8. — Waverly  Hill  Sanatorium,  Waverly  Hill,  Ky.  J.  J.  Gaffxey.  Architect.  View  from  the 
Rear  Showing  a  Method  or  Using  the  Top  and  Side  of  a  Hill  in  Order  to  Obtain  a  Position 
Below  the  Buildings  for  the  Power  Plant.  (See  illustration  5  for  further  description  of  this 
institution.) 


be  assembled  to  house  it  either  in  the  basement  of  one  of  the  buildings  or  in  a  power  house 
especially  constructed  for  it;  but  there  seems  to  be  a  strong  feeling  against  installing  it  in 
the  basement  of  any  sanatorium  or  hospital  building,  as  the  heat  from  the  boilers  is  very 
disagreeable  and  the  noise  and  dust  penetrate  to  other  parts  of  the  structure.  If  the  in- 
stitution grows  the  time  is  sure  to  come  when  it  will  have  to  be  removed,  and  therefore  it  is 
advisable  to  house  even  a  very  small  plant  in  an  isolated  power  house  when  starting  an 
institution.  This  should  be  placed  below-  the  site  of  all  buildings  to  be  heated,  in  order  to 
allow  the  return  by  gravity,  of  condensed  steam  or  hot  water  from  the  heating  apparatus, 
and  if  this  is  impossible  where  the  land  is  fiat,  a  pit  must  be  dug  under  the  plant  for  this 
purpose.  In  choosing  a  site  the  question  of  placing  the  building  beside  a  siding  or  spur  from 
a  railroad  should  be  considered,  for  such  a  position  will  greatly  reduce  the  expense  of  hand- 
ling coal  and  ashes.  The  administration  and  all  other  buildings  to  be  heated,  should  be 
grouped  near  enough  to  the  power  house  to  allow  connecting  them  by  a  concrete  or  brick 
tunnel  three  feet  wide  by  six  feet  high,  as  much  trouble  and  expense  will  be  saved  if  the 
pipes  and  wires  connecting  the  buildings  can  be  inspected  through  their  full  length  at  all 
times. 

The  building  should  be  of  brick  or  reinforced  concrete  construction,  one  story  high 
and  divided  into  an  engine  room,  boiler  room,  oil  room  and  dressing  room,  containing 
toilets  and  shower  baths.  The  coal  bins  should  also  be  of  concrete  ha\ing  a  capacity  of 
six  or  eight  carloads,  placed  on  the  outside  of  the  building,  and  arranged,  if  possible,  so  that 
the  coal  can  be  dumped  directly  into  them  from  the  cars. 

In  equipping  various  power  houses  the  question  of  installing  low  for  high  pressure 
boilers  and  substituting  gasolene  or  oil  for  steam  engines,  in  producing  heat  and  power,  has 
been  carefully  investigated.  It  now  seems  to  be  the  consensus  of  opinion  among  engineers 
and  architects  having  large  experience  with  isolated  powder  plants,  that  the  use  of  high 
pressure  boilers  with  steam  engines  is  the  cheapest  method,  at  the  present  time,  of  produc- 

46 


Administration  Buildings 


ing  light,  heat  and  power  for  public  institutions  when  the  exhaust  steam  is  used  for  heating. 
If  this  method  is  adopted  the  equipment  for  the  power  house  should  consist  of: 


Two  Steam  Boilers  of  loo  H.  P.  each 
One  Water  Tank  for  Service  Hot 

Water 
Two  Steam  Engines 
Two  Electric  Generators 
One  Storage  Battery 
One  Oil  Separator 


One  Coal  Truck  and  Track 

One  Open  Feed  Water  Heater 

Two  Water  Pumps 

One  Fire  Pump 

Two  Mechanical  Stokers 

One  Set  of  Machinist's  Tools 

One  Power  Drill  and  Lathe 


The  building  with  equipment  will  cost  about  $15,000. 


EXAMPLE  OF  POWER  HOUSE 

The  Preventorium  for  Children,  Farmingdale,  N.  J.,  Power  House  (Illus- 
tration 19).  This  is  a  two  story  building,  59  feet  wide  by  43  feet  deep.  The  first  story  walls 
are  of  hollow  tile  with  reinforced  concrete  construction,  and  fireproof  partitions  of  hollow 
tile.  There  are  two  complete  power  units,  each  consisting  of  a  high  pressure  horizontal 
tubular  boiler,  a  steam  turbine  directly  connected  with  an  electric  generator  and  a  switch- 
board. There  is  also  an  ice-making  niachine,  a  large  scale  for  weighing  fuel  and  a  hot 
water  storage  tank.  The  second  floor  houses  the  laundry  and  has  partitions  of  frame, 
covered  with  wooden  lath  and  plaster.     It  is  divided  into  a  receiving  and  sterilizing  room 


No 


19. — Preventorium  for  Children,  Farmingdale,  N.  J.  Scopes  &  Feustmaxn,  and  Walter  W. 
JuDELL,  Associated  Architects.  Power  House  and  Laundry.  Front  and  Side  Elevations 
WITH  First  and  Second  Floor  Plans.  (See  illustrations  12,  27  and  95  for  further  description  of  this 
institution.) 


Section  II 


No.    20. — District   Tuberculosis  Hospital,   Lima,    Ohio.     McLaughlin   &   Hulskix,   Architects. 

A  Part  of  the  Basement  Floor  Plan,  Showing  Arrangement  of  Laundry  and  Power  Plant, 

IN  AN  Administration  Building.     (See  illustration  43  for  further  description  of  this  institution.) 


equipped  with  a  pressure  steam  sterilizer,  a  general  laundry  room  containing  metal  washers, 
an  extractor,  mangles  and  steam  pressure  pumps  and  electric  motors  for  running  the  ma- 
chinery, an  ironing  room  eqviipped  with  electric  irons,  a  distributing  room,  and  a  room 
over  the  ice-machine  from  which  ice  is  distributed  to  the  small  refrigerators  in  the  various 
buildings. 

The  third  or  attic  floor  is  divided  into  four  large  rooms  and  bath  for  the  male  help, 
and  is  reached  by  a  separate  stairway  which  does  not  open  on  to  the  laundry  floor. 

The  building  cost  $9,000  and  the  mechanical  equipment  of  the  institution,  including 
water  supply  and  sewage  disposal,  cost  $32,000. 

The  Laundry 

The  laundr}'  should  be  housed  in  a  separate  building,  thirty  feet  wide  by  fifty  feet 
long,  and  one  and  one-half  stories  high,  open  to  the  peak  and  constructed  of  reinforced  con- 
crete or  brick,  or  it  can  be  placed  in  the  power  house  and  made  a  part  of  that  building.  It 
should  be  divided  into  four  rooms  for  receiving  the  soiled  clothes,  washing,  ironing  and  sorting. 
Laundries  placed  in  the  basements  of  administration  buildings  have  been  unsatisfactory,  as 
proper  ventilation  is  impossible.  The  building  should  have  a  cement  floor  and  if  finished 
on  the  interior,  plastered  with  hard  plaster  and  painted.  The  hot  water  and  steam  as  well 
as  the  power  for  driving  the  machinery  can  be  supplied  from  the  power  house  and  the 
equipment  should  consist  of 


Two  Washers 

One  Centrifugal  Wringer 

Two  Mangles 

Two  Drying  Racks 


One  Tank  for  Mixing  Soap  with  Steam 

Two  Sets  of  Irons 

One  Set  of  Sorters'  Shelves 

Six  Tables 


Ip  some  districts  a  cistern  for  storing  rain  water  will  be  needed.     The  entire  plant  including 
the  cistern  can  be  constructed  and  equipped  for  from  $6,000  to  $10,000. 

48 


Administration  Buildings 


Sterilizing  Room 

Connected  with  the  laundry  there  should  be  a  sterilizing  room  about  ten  feet  wide 
by  twenty  feet  long,  constructed  of  concrete  with  a  cement  floor  and  equipped  with  a 
rectangular  steam  disinfecting  chamber,  thirty  inches  wide,  fifty  inches  high  and  eighty- 
four  inches  long.  This  chamber  is  usually  built  with  an  inner  and  outer  shell  of  steel  plates 
securely  ri^'eted  to  the  end  frames  and  closed  by  doors  at  both  ends  hung  from  da\-it  cranes. 
They  are  also  equipped  with  a  wrought  iron  car,  an  inside  and  outside  car  truck,  two  cast 
iron  supports,  a  thermometer,  steam  pressure  gauge,  \acuum  and  pressure  gauge  and  two 
safety  valves.  With  an  instrument  of  this  size,  beds,  bedding,  linen  and  clothes  needing 
disinfecting  can  be  sterilized.  The  room  and  sterilizer  in  connection  with  the  laundry,  if 
placed  near  the  power  house,  can  be  constructed  and  installed  for  about  $1,500.  (See  Illus- 
tration 21.) 

Vacuum  Cleaning  Plant 

This  method  of  cleaning  sanatoria  and  hospitals  is  becoming  popular.  It  is  said 
that  from  an  economical  point  of  view  it  will  pay  to  ha\'e  it  installed,  and  will  ssive  in  labor 
fifty  per  cent  of  the  cost  of  cleaning,  that  it  also  reduces  to  a  minimum  the  wear  on  paint, 
plaster,  wood-work,  decorations  and  other  finish  of  the  buildings.  By  this  method  clean- 
ing can  be  done  without  stirring  up  the  dust  and  dirt,  and  waste  of  all  kinds  which  cannot 
be  reached  by  the  ordinary  means,  is  easily  removed  from  corners,  nooks  and  cracks.  The 
usual  plant  installed  for  institutions  is  operated  by  electricity  obtained  from  the  generator, 
which  supphes  the  current  for  lighting.  The  power  necessary  is  about  one  hundred  and  ten 
volts,  but  when  it  is  not  available  the  plant  can  be  operated  by  a  two  cylinder  ten  horse 
power  gasolene  engine. 

The  vacuum  cleaning  machine  itself  is  placed  in  the  power  house  or  basement  of  the 
administration  building,  and  consists  of  a  reciprocating  pump,  with  a  motor  on  the  same 
frame,  and  a  separator.  It  is  connected  with  all  the  buildings  by  a  main  trunk  line  pipe, 
giving  off  vertical  pipes  ending  in  ser\'ice  inlets  at  convenient  points  where  a  hose  can  be 
attached  for  the  cleaners.  These  inlets  are  usually  placed  in  the  walls  of  the  corridors  near 
the  floor  but  can  be  installed  at  any  point  desired.  The  hose  which  connects  them  with 
the  cleaner  can  be  fifty  feet  long,  if  desired,  and  the  intakes  located  at  points  where  a  circle 
of  fifty  feet  from  them  will  reach  every  place  to  be  cleaned.  The  dust  and  dirt  is  conveyed 
from  the  apartment  being  cleaned,  through  the  hose,  \ertical  lines,  and  trunk  Hues,  to  the 
separator,  where  about  ninety-eight  per  cent  of  the  dirt  is  taken  out  of  the  air  drawn  into 
the  pipes.  The  balance,  or  two  per  cent  of  the  dust  and  dirt,  passes  through  the  machine 
and  out  of  an  exhaust  pipe  which  discharges  into  a  flue  or  other  convenient  place  to  reach 
the  open  air.  A  vacuum  plant  suitable  for  a  sanatorium  while  cleaning  an  apartment  re- 
moves about  two  hundred  and  forty  cubic  feet  of  air  per  minute.  If  this  is  replaced 
through  open  windows  by  pure,  fresh  air,  the  rooms  will  be  well  ventilated  while  the  ma- 
chine is  in  use. 

The  pump  and  separator  will  cost  $1,500,  the  piping  and  installation  of  the  plant 
about  $1,000  more,  making  a  total  cost  of  the  plant  of  $2,500.  Three  complete  sets  of 
sweepers  and  tools  are  supplied  with  the  machine  and  e.xtra  sets  consisting  of  a  floor  sweeper, 
floor  brush,  renovator  and  tufter  cost  $75.00. 

Ice  House  or  Cold  Storage  Plant 

Ice  is  an  absolute  necessity  in  a  hospital  or  sanatorium;    therefore,  some  means  of 
manufacturing  or  storing  it  must  be  supplied.     The  construction  of  an  ice-house  is  a  simple 
4  49 


Section  11 


No.  21. — A  Rectangular  Steam  Disinfecting  Chamber,  for  Use  in  Connection  with  the  Laundry. 
A  Convenient  Shape  for  Tuberculosis  Hospital  and  Sanatorium  Work.     Loaned 

BY  The  Kny-Sheerer  Company. 


matter  for  a  small  institution,  if  natural  ice  can  be  obtained  on  or  near  the  site,  but  the 
installing  of  a  refrigerating  plant  is  usually  cheaper  for  large  institutions  than  the  building 
and  filling  of  an  ice  house.  If  a  cold  storage  plant  is  constructed  it  should  be  placed  in  the 
administration  building  or  store  house  and  arranged  to  provide  coils  for  the  various  re- 
frigerators.    The  cost  will  be  from  $i,8oo  to  $3,000. 

The  Carpenter  and  Paint  Shop 

A  repair  shop  may  be  combined  with  one  of  the  barns,  the  industrial  shop,  or  con- 
structed as  a  separate  building.  It  should  be  about  ninety  feet  long  by  twenty  feet  wide, 
constructed  of  frame,  brick,  or  concrete,  one  story  high,  with  peaked  roof  and  an  air  space 
above  the  ceiling.  It  can  be  divided  into  a  carpenter's  room,  paint  room,  store-room  and 
storage  room  for  drying  lumber;  and  equipped  with  a  circular  power  saw,  necessary  carpen- 
ter and  cabinet-makers'  tools,  and  a  painter's  outfit.  The  man  in  charge  should  be  a  good 
practical  cabinet-maker  able  to  repair  furniture  and  the  woodwork  of  the  buildings,  and 
have  a  painter  as  one  of  his  assistants.  This  department  has  a  large  share  in  the  up-keep 
of  the  entire  institution  and  will  well  repay  the  investment  of  $1,500  to  $2,000  necessary 
to  build  and  ecjuip  it. 

The  Store  House,  Bakery  and  Scale  House 

A  large  amount  of  storage  space  is  a  necessity  in  a  sanatorium  or  hospital.  Gro- 
ceries, grains,  vegetables  and  other  winter  food  supplies,  furnishings,  linens,  clothes,  and 
many  things  for  the  farm  or  grounds  must  be  bought  in  bulk  or  numbers,  in  order  to  obtain 
fair  prices.  At  many  institutions,  portions  of  the  basements  and  cellar?  of  the  various 
buildings  are  used  as  storage  rooms,  but  this  is  a  wasteful  and  incon^•enient  method  of 
administration  and  should  be  abandoned.  Buildings  are  more  sanitary  when  rightly  con- 
structed without  arrangements  for  storage  purposes,  but  with  low  foundations  and  cellars 
having  a  good  circulation  of  air,  so  there  is  no  good  reason  for  housing  stores  in  this 
manner. 

50 


Administration  Buildings 


It  has  been  tried  and  found  very  satisfactory,  as  well  as  a  great  help  in  reducing 
expenses,  to  have  a  separate  store  house  under  the  care  of  an  employee  who  gives  his  time  to 
the  details  of  ordering  and  distributing  supplies. 

At  all  large  institutions  the  bakery  should  be  separate  from  the  kitchen.  In  a 
number  of  instances  it  has  been  placed  in  the  basement  of  administration  buildings,  but 
this  is  not  satisfactory,  as  it  requires  the  baker  and  his  assistants  to  work  in  a  room  that  is 
hot  and  hard  to  ventilate.  A  small  separate  structure  connected  with  the  general  store 
house  or  as  a  part  of  it,  should  be  built  for  this  purpose;  the  bake  room  to  be  about  twelve 
by  fifteen  feet  with  the  oven  constructed  outside  the  walls. 

In  connection  with  the  store  house  and  bakery  there  should  be  a  platform  scale. 
The  weighing  room  may  be  a  separate,  small  frame  building,  or  a  part  of  the  store  house, 
with  the  scale  platform  on  the  outside,  arranged  so  that  trucks  and  wagons  can  conveni- 
entlv  be  run  over  it.  The  scale  will  cost  about  $80.00.  There  is  no  doubt  that  the  savins: 
made  by  a  careful  oversight  and  concentration  of  the  stores  and  the  weighing  of  the  grain 
and  other  supplies  bought  in  bulk,  will  soon  pay  for  the  construction  of  a  store  house.  A 
bakery  and  store  house  eciuipped  with  a  scale  can  be  built  for  from  Si, 200  to  ^2,000. 

Green  House,  Forcing  Beds  and  Vegetable  Cellar 

A  green  house  for  vegetables,  plants  and  flowers  can  be  placed  near  the  power  house, 
and  by  using  the  surplus  steam  for  heating  it  and  the  forcing  beds,  a  supply  of  fresh  lettuce, 
radishes,  onions,  rhubarb,  spinach,  parsley,  turnips  and  other  green  vegetables  may  be  pro- 
duced during  the  entire  winter.  This  building  should  have  in  connection  with  it,  about 
200  feet  of  cold  frame  or  glass  forcing  beds,  and  a  root  or  vegetable  cellar  constructed  of 
concrete,  half  above  and  half  below  ground  level,  with  bins  and  di\-isions,  of  the  same 
material.  A  root  cellar  is  a  need  which  is  generally  put  ofif,  with  the  idea  of  using  the  base- 
ments of  the  building  for  this  purpose,  but  because  of  the  pipes  and  mains  from  the  heating 
plant,  basements  often  cannot  be  used. 

The  expense  of  building  a  green  house,  frames  and  root  cellar  will  be  about  $5,000. 

Garage,  Barn,  Stable  and  Farm  Outfit 

It  is  necessary  to  have  a  stable  for  farm,  carriage  and  riding  horses,  in  conjunction 
with  a  barn  for  housing  saddles,  harness,  carriages,  wagons,  machinery  and  tools,  and  a 
garage  for  motors  when  institutions  are  located  in  more  or  less  secluded  sections  of  the 
country.  This  building  can  be  constructed  of  frame,  brick,  concrete,  tile,  or  reinforced 
concrete,  and  may,  if  desired,  combine  with  it  under  one  roof  the  industrial,  carpenter  and 
paint  shops.  A  barn  can  be  erected  for  from  $5,000  to  Sio.ooo,  depending  upon  the  size 
and  finish  of  the  building.  The  following  list  obtained  from  a  state  sanatorium,  is  a  partial 
outfit  of  farm  tools  and  machinery,  which  will  be  needed  if  a  farm  is  a  part  of  the  institution. 


Two  Farm  Wagons 

One  Deli\ery  Wagon 

One  Wagon  Scale 

Two  Double  Sets  of  Harness 

One  Single  Set  of  Harness 

One  Sulky  Plow 

One  Ordinary  Plow 

One  Harrow 

One  ^Slowing  Machine 

One  Side  Delivery  Rake 


One  Potato  Planter 

One  Potato  Digger 

One  Corn  Planter 

One  Corn  Binder 

One  Power  Feed  Mill 

One  Power  Hay  Cutter 

One  Hand  Cart 

Two  Two-horse  Cultivators 

One  One-horse  Cultivator 

One  Fanning  Mill 


Section  II 


One  Hay  Loader 

Six  Hay  Slings 

One  Hay  Carrier  and  Rope 

Two  Hay  Racks 

One  Horse  Lawn  Mowing  Machine 

One  Horse  Lawn  Roller 

One  ^Meadow  Seeder 

One  Manure  Sejiaralor 


One  Feed  Cooker  for  Garbage 

One  Potato  Sprayer 

Two  Scythes 

Two  Corn  Shredders 

One  Set  of  Garden  Tools 

Shovels 

Spades 

Other  Small  Farm  Imi)lements 


The  Cow  Barn 

One  method  of  keeping  down  the  cost  of  maintaining  an  institution  is  through  own- 
ing cows  and  producing  milk  and  butter.  Some  institutions  have  shown  that  the  purchase 
of  milk  from  outside  sources  costs  double  the  amount  necessary  to  produce  it  on  the  site. 
It  is  estimated  that  an  institution  for  one  hundred  patients  will  consume  the  milk  from 
thirty-five  cows,  as  one-fourth  of  the  herd  is  usually  dry. 

\  cow-barn  should  be  kept  clean  and  the  animals  made  comfortable.  This  is  most 
easilv  done  if  the  floor  is  of  concrete,  well  drained  and  the  building  arranged  to  adm.it 
plentv  of  light  and  air.  The  cows  should  be  held  by  movable  stanchions,  facing  each  other 
on  either  side  of  a  feeding  alley  in  the  centre  of  the  building. 

Such  a  barn  may  be  constructed  of  reinforced  concrete,  tile,  bricks,  or  wood,  the 
dimensions  about  thirty-six  feet  wide  by  eighty-six  feet  long,  one  story  high,  with  side  walls 
seven  feet  six  inches  high  and  nine  feet  clear  at  the  centre.  The  roof  can  be  supported  by 
trusses  and  covered  with  shingles  or  composition  roofing,  the  interior  sealed  with  smooth 
painted  tongued  and  .grooved  boards  or  plastered  over  metal  lath.  The  concrete  floor 
ought  to  be  on  a  slight  grade,  drained  at  one  end,  and  by  gutters  in  the  manure  alleys  four- 
teen inches  wide  by  six  inches  deep.  The  ventilation  should  be  carried  out  through  a 
double  system  of  air  spaces  in  the  walls,  following  the  King  method  of  heating  and  venti- 
lation by  means  of  the  heat  given  off  by  the  cows.  The  central  feeding  alley  should  be 
nine  feet  wide,  the  manure  alleys  four  feet  wide,  and  the  cross  alley  di\-iding  the  stalls  into 
sections  seven  feet  wide.  The  stalls  should  be  three  feet  wide,  with  a  graded  depth  for 
different  sized  cows  of  from  four  feet  eight  inches  to  five  feet,  and  constructed  of  iron  piping, 
fitted  with  chain  hung  stanchions.  The  mangers  can  be  made  of  concrete  in  the  form  of 
a  long  trough  for  each  section,  having  a  slight  fall  toward  one  end  so  that  they  can  be 
washed,  flooded  with  water  and  drained. 

The  Silo 

A  silo  is  a  tank  in  which  fodder  in  the  green  state  is  preserved.  It  is  usually  round 
and  can  be  built  of  reinforced  concrete,  brick,  concrete  tile  or  wood  and  is  considered  one  of 
the  best  and  cheapest  buildings  for  storing  and  handling  fodder  for  feeding  a  herd  of  milch 
cows.  A  silo  large  enough  to  store  fodder  to  feed  a  herd  of  thirty-fi\'e  cows  for  six  months 
should  have  a  capacity  of  one  hundred  and  twenty-six  tons,  a  diameter  of  fifteen  feet,  a 
height  of  thirty-four  feet,  and  will  require  about  eight  and  one-half  acres  of  land  planted  with 
corn  to  fill  it.  It  should  be  placed  beside  the  cow  barn  in  a  convenient  position  so  that  the 
fodder,  which  is  heavy,  can  be  handled  easily. 


The  Milk  House 

A  milk  house  should  be  arranged  to  concentrate  the  work  of  the  milkers  and  care 
for  the  milk  by  the  best  methods.     Hot  water  and  steam  will  be  needed  and  can  be  piped 


Administration  Buildings 


from  the  power  house  or  supplied  by  a  small  vertical  boiler  installed  in  the  building.  A 
wash  room  for  the  milkers  should  be  placed  so  it  can  be  entered  without  passing  through 
the  other  parts  of  the  milk  house.  Such  a  building  constructed  of  frame  or  tile,  twenty- 
one  feet  wide  by  twenty-two  feet  long,  one  story  high,  with  peaked  roof,  plastered  on  the 
interior,  with  round  corners,  and  cement  floors,  will  be  found  con\-enient.  It  may  be  di- 
vided into  four  rooms  ten  feet  high  in  the  clear,  and  connected  with  the  barn  by  an  enclosed 
covered  passageway  seven  feet  wide.  The  weighing  room  is  eight  feet  wide  by  eight  feet 
deep  and  contains  a  desk  for  records,  a  scale  for  weighing  each  milking,  and  a  platform  under 
a  movable  funnel  for  conveying  the  milk  to  the  cooler  in  the  adjoining  room.  The  bottling 
room  is  eight  feet  wide  by  twelve  feet  long,  equipped  with  a  cooler,  bottler,  and  a  refrigerator. 
The  utensil  wash  room  is  twelve  feet  wide  by  thirteen  feet  long,  fitted  with  hot  and  cold 
water  faucets,  two  large  sinks,  a  sun  rack  and  a  utensil  sterilizer  built  into  the  wall  so  that 
the  bottles  placed  in  it  from  the  wash  room  can  be  removed  in  the  bottling  room  beside  the 
spout  of  the  cooler.  The  milkers'  wash  and  locker  room  is  eight  feet  wide  by  thirteen  feet 
long,  containing  two  hand  wash  basins,  running  hot  and  cold  water,  and  four  iron  lockers  for 
towels  and  milkers'  clothes. 

The  capacity  of  the  barn  is  thirty-five  cows  and  the  plant  complete,  including  barn, 
milk  house,  silo,  and  a  cow  shed,  can  be  constructed  of  concrete  tile  for  from  §5,000  to 
$10,000. 

Chicken  and  Hog  Houses 

Chickens  and  hogs  are  also  a  part  of  the  equipment  of  many  sanatoria.  It  is  said 
that  fifteen  hundred  to  two  thousand  hens  will  supply  chickens  and  eggs  through  the  entire 
year  for  an  institution  of  one  hundred  patients  if  the  surplus  of  eggs  produced  in  the  spring 
and  summer  are  preserved  in  lime  or  by  cold  storage.  An  outfit  including  chickens,  colony 
houses,  incubators  and  other  equipment  costs  about  $3,000. 

There  is  enough  refuse  from  the  tables  of  large  institutions  to  feed  twenty-five  hogs 
and  the  annual  income  from  this  number  at  one  sanatorium  is  about  four  hundred  dollars 
a  year.  In  order  to  make  these  animals  profitable  a  healthy  herd  is  necessary;  therefore, 
care  must  be  used  to  eliminate  those  with  disease  when  purchasing  them.  To  prevent  the 
possibility  of  infection  later  a  steam  cooker  should  be  installed  and  all  table  refuse  used  for 
feeding  passed  through  it.  A  sanitary  hog  house  with  a  wire  screened  run  can  be  built  for 
$1,000. 

Sewage  Disposal  Plant 

A  hospital  or  sanatorium  which  is  not  situated  close  enough  to  some  town  for  con- 
nection with  its  sewer  system  will  need  a  sewage  disposal  plant,  the  method  of  sewage 
disposal  to  be  installed  depending  largely  upon  the  site  obtained  for  the  institution.  Where 
a  farm  is  part  of  the  property  the  simplest  methods  can  be  used,  such  as  a  septic  tank  with  a 
subsoil  distributing  field.  A  small  disposal  plant  of  this  kind  to  serve  a  limited  number  of 
people  may  consist  only  of  a  septic  tank  about  twenty  feet  by  twenty  feet  and  six  feet  deep, 
divided  into  two  compartments  and  distributing  the  sewage  at  intervals  to  the  subsoil  of  a 
level  cultivated  field  by  open  jointed  agricultural  drain  tiles,  laid  at  a  depth  of  about  ten 
inches  from  the  surface.  The  disposal  field  should  be  divided  into  sections,  and  the  sewage 
discharged  into  one  section  after  another,  allowing  enough  time  to  intervene  after  the  use 
of  each  one  before  it  is  used  again  for  the  absorption  of  the  entire  discharge.  It  is  estimated 
that  from  one  to  three  feet  of  drain  tile  according  to  the  nature  of  the  soil  will  dispose  of  one 
gallon  of  sewage. 

53 


Section  11 


Where  the  site  of  a  kirj^e  sanatorium  is  small  or  a  running  stream  or  lake  is  near  and 
below  the  buiklings,  filter  beds  must  be  used  in  connection  with  the  septic  tanks.  The 
eilluent  of  the  septic  tanks  is  then  passed  through  siphons,  which  intermittently  discharge  a 
part  of  the  contents  of  the  tank  evenly  over  the  surface  of  a  filter.  Usually  two  or  more 
filters  are  used,  the  sewage  being  deposited  upon  one  after  another  automatically.  Differ- 
ent conditions  require  a  variation  of  methods  in  sewage  purification  and  numerous  varieties 
of  filters  have  been  devised.  Sand,  gravel,  broken  stone,  clinker,  coke  and  other  material 
are  used  with  success,  the  object  being  to  expose  the  contents  of  the  septic  tank  to  the  air 
and  the  action  of  bacteria,  and  in  this  manner  purify  the  sewage  as  it  passes  through  the 
filter  and  before  it  is  allowed  to  flow  away.  It  is  estimated  that  a  septic  tank  of  the  dimen- 
sions given  above  and  two  sand  fillers  twenty-five  by  one  hundred  feet  in  area  and  four 
feet  deep  each,  will  purify  the  sewage  from  about  three  hundred  people  and  will  cost  from 
$I,OOD  to  $_^,ooo. 


EXAMPLES  OF  ADMINISTRATION  BUILDINGS 

Eudowood  Sanatorium,  Towson,Md.,  Administration  Building  (Illustration 
22).  This  building  was  rebuilt  and  greatly  enlarged  in  1908,  only  a  part  of  the  old  building 
having  been  retained  as  a  nucleus,  and  even  this  was  entirely  rearranged.  The  main  or 
central  portion  was  originally  a  country  residence.  It  is  forty-eight  feet  wide  by  thirty- 
five  eet  deep,  of  frame  construction,  externally  covered  with  shingles,  two  stories  with  a 
high  basement  and  a  third  or  attic  story  under  the  roof  supplied  with  light  by  dormer 
windows.  The  foundation  is  of  native  stone  carried  well  up  above  the  ground  level  in 
order  to  give  light  and  air  to  the  basement.  There  is  a  porch  twelve  feet  wide  across  the 
entire  front  of  the  first  and  second  stories  and  the  interior  on  the  first  floor  is  divided  in  the 
centre  from  front  to  rear  by  a  broad  hall  twelve  feet  wide.  An  office  15  feet  wide  by  15 
feet  deep,  and  a  library  12  feet  wide  by  15  feet  deep,  are  on  one  side  of  the  hall,  and  on  the 
other  a  physician's  office  8  feet  wide  by  17  feet  deep,  an  examination  room  7  feet  wide  by  12 
feet  deep  and  a  staff  dining  room  12  feet  wide  by  17  feet  deep. 

The  second  story  is  arranged  into  two  separate  apartments,  one,  of  two  large  rooms 
and  bath  for  the  superintendent,  and  the  other,  of  three  small  rooms  and  bath,  for  the 
matron.  The  third  story  is  divided  into  four  chambers  and  a  bath  for  the  nurses.  The 
new  additions  consisted  of  two  large  wings  and  a  rear  extension.  The  side  wings  are  both 
24  feet  wide  by  52  feet  long,  connected  to  the  sides  of  the  main  building  by  passageways 
fourteen  feet  long,  making  the  entire  front  one  hundred  and  eighty-three  feet  long.  The 
rear  extension  is  sixty-eight  feet  long,  also  joined  to  the  main  structure  by  a  covered 
corridor.  The  wing  to  the  right  of  the  building  consists  of  one  large  room  23  feet  deep  by 
50  feet  long,  with  a  ten  foot  porch  on  the  front  given  up  to  amusement  {purposes.  The  wing 
to  the  left  is  an  infirmary,  divided  into  two  small  wards  20  feet  wide  by  18  feet  deep,  for  four 
beds  each,  with  toilets  and  baths,  and  a  porch  in  front  ten  feet  wide. 

The  rear  extension  contains  a  spacious  well  lighted  dining  room  54  feet  wide  by  35 
feet  deep,  having  a  seating  capacity  of  sixty  patients  and  containing  a  large  open 
fireplace.  Behind  this  room  in  the  same  extension  is  a  kitchen  24  feet  wide  by  iS  feet 
deep,  a  servants'  dining  room,  pantry,  sewing  room  and  storage.  The  rear  extension 
was  built  so  as  to  allow  the  patients  to  enter  the  dining  room  at  the  rear  of  the 
administrative  offices,  thus  avoiding  the  tracking  of  dirt  and  nnul  through  the  main 
building,  and  in  order  to  cut  off  the  noise  usually  made  by  a  large   number  of  people 

54 


Administration  Buildings 


No.  22. — Eudowood  Sanatorium,  Towson,  Md.  Archer  &  Ali.i:n.  Architects.  The  .\d.\iixistra- 
TU)N.  Recreation.  Infirmary  and  Service  Bcildincs.  \'ie\v  of  Front  F.lev.\tion  axd  Floor 
Plans.  Administrative  Capacitv,  ioo  Patients.  F.stimated  Cost,  Sbo.ooo.  (See  illustrations  6i 
and  S3  for  furlher  cicsiriplion  of  this  institution.) 


55 


Section  11 


dining  together.  The  extensions  are  constructed  of  frame,  covered  with  shingles  that  har- 
monize with  the  exterior  of  the  main  section,  and  the  windows  of  the  entire  Inn'kHng  are 
fitted  on  the  outside  with  slat  blinds  in  order  to  shut  out  the  heat  and  light  during  the 
sununer.  During  the  remodeling  there  was  also  installed  a  central  hot  water  \"acuum 
plant  to  heat  the  entire  structure. 

These  improvements  have  resulted  in  providing  a  group  of  buildings  extending 
from  one  centre  and  admirably  adapted  to  the  requirements.  They  have  also  doubled 
the  previous  administrative  facilities,  there  now  being  a  capacity  for  one  hundred  patients, 
at  a  cost  of  about  $50,000. 

Maine  State  Sanatorium,  Hebron,  Me.,  x\dministration  Building  (Illustration 
23).  This  building  is  two  full  stories  with  a  basement,  and  a  third  story  over  the  centre. 
It  is  constructed  of  red  brick  with  gray  brick  and  concrete  trimmings  for  the  window  caps, 
plates,  etc.  The  roof  is  tar  and  gravel,  drained  in  the  centre  because  of  the  danger  of 
snowslides.  The  main  front  is  147  feet  long  by  53  feet  wide,  with  an  extension  to  the  rear 
at  one  end  66  feet  deep  by  33  feet  wide.  The  front  basement  contains  a  small  medical 
suite,  divided  into  a  laboratory,  pharmacy,  examination  and  waiting  rooms,  a  sterilizing 
chamber,  billiard  and  storage  rooms.  In  the  rear  extension  of  the  basement  is  a  section 
for  servants'  cjuarters. 

The  first  floor  is  flanked  on  the  front  by  a  porch  12  feet  wide  by  147  feet  long  and 
on  the  south  side  10  feet  wide  by  36  feet  long.  It  is  divided  into  a  large  dining  room  and 
an  assembly  room,  both  38  feet  wide  by  36  feet  deep,  and  connected  through  the  centre 
of  the  building  by  a  corridor  with  rooms  on  both  sides.  On  the  front  is  a  parlor  17  feet 
wide  by  24  feet  long,  an  office  15  feet  wide  by  17  feet  long,  and  a  waiting  room  10  feet  wide 
by  17  feet  long.  On  the  rear  is  a  reading  room  16  feet  wide  by  ig  feet  long  and  toilets, 
washrooms  and  other  conveniences.  The  rear  extension  on  the  first  floor  contains  a  kitchen 
30  feet  wide  by  18  feet  deep,  and  serving  room  16  feet  wide  by  17  feet  deep,  pantry,  cold 
storage  and  servants'  dining  room  19  feet  wide  by  16  feet  deep.  The  second  floor  is 
divided  by  a  long  corridor  se\'en  feet  wide  running  down  the  centre  of  the  building,  with 
good-sized  rooms  on  each  side  for  the  superintendent,  staff,  patients  and  visitors, 
well  supplied  with  closets,  baths,  toilets  and  other  conveniences.  This  story  is 
also  flanked  on  the  front  by  a  porch  12  feet  wide  by  57  feet  long,  and  one  on  the  south 
side  10  feet  wide  by  36  feet  long. 

The  third  story  over  the  centre  of  the  block  is  devoted  to  quarters  for  nurses. 

The  building  is  intended  for  administration  purposes,  offices,  accommodations  for 
trustees  and  visitors,  and  for  the  housing  of  patients  who  are  able  to  be  up  and  around. 

The  interior  is  plastered  over  metal  lath  with  hard  plaster,  having  round  corners 
and  sanitary  base,  thus  eliminating  all  angles  in  the  endeavor  to  make  it  strictly  sanitary. 
The  entire  building  is  as  nearly  fire-proof  as  possible,  with  a  smooth  and  simple  wood-work 
and  is  intended  to  afford  administrative  facilities  for  an  institution  of  one  hundred  patients, 
at  an  estimated  cost  of  $50,000. 

Iowa  State  Sanatorium,  Oakdale,  la..  Administration  Building  (Illustration 
24 j.  This  is  a  substantial  brick  veneered  structure  63  feet  wide  by  70  feet  deep,  two  stories 
high,  with  a  basement  and  attic  story.  The  foundations  are  of  stone  and  the  building  is 
trimmed  with  wood  painted  white,  and  surrounded  by  a  veranda  on  two  sides  of  the  first 
floor,  the  roof  of  which  is  supported  by  large  round  wooden  columns.  The  basement 
contains  storage  rooms  and  a  dining  room  for  the  male  help.     The  main  entrance  hall  on 

56 


Administration  Buildings 


Third 
TLOCR 


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f^UPSti      OuaOTCRS                     1 

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i 

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No.  23.— Maine  State  Sanatorium,  Hebron,  Me.  T.  C.  Stevens  &  J.  H.  Stevens,  Architects. 
Administration  Blildinc.  \'ie\v  of  Front  FIlevation  and  Floor  Plans.  .Administrative 
Capacity,  too  Patients.  Estimated  Cost,  $50,000.  (See  illustrations  11  and  58  for  further  descrip- 
tion of  this  institution.) 

57 


Section  II 


the  first  floor  is  12  feet  wide  by  30  feet  long,  with  a  physician's  suite  on  one  side  consisting 
of  a  reception  room  12  feet  wide  by  16  feet  long,  a  small  examining  room  9  feet  wide  by 
12  feet  long,  a  second  examination  room  8  feet  wide  by  16  feet  long,  and  a  small  passage- 
way 4  feet  wide  and  g  feet  long.  On  the  opposite  side  of  the  main  hall  is  a  rest-room  22 
feet  wide  by  25  feet  long,  a  small  hall  7  feet  wide  and  22  feet  long,  running  down  to  the 
patients'  entrance,  and  a  small  reception  room  10  feet  wide  by  12  feet  long.  On  the 
opposite  side  of  the  patients'  hall  and  at  the  end  of  the  entrance  hall  is  a  large  dining  room 
30  feet  wide  by  43  feet  long  which  will  seat  one  hundred  and  twenty-five  persons,  a  pantry 
10  feet  wide  by  22  feet  long,  a  kitchen  16  feet  wide  by  22  feet  long,  stairs  to  the  cellar, 
a  refrigerator,  and  other  conveniences.     The  second  floor,  which  is  divided  into  quarters 


af^ 


EEEr 


No.  24.— Iowa  State  Sanatorium,  Oakdale,  la.     H.  F.  Likbbi,,  Architixt.     Administr.atio.\  Hcild- 

ixG.     View  of  Front  Elevation  and  Floor  Plans.     Administrative  Capacity,  100  Patients. 

Estimated  Cost.  S23.000.   (Sec  illustralions  29.  84  and  103  for  further  description  of  this  institution.) 

58 


Administration  Buildings 


^FniiTfflP^ .  _ 


U   lU 


No.  25.— Manitoba  Sanatorium,  Ninette,  Manitoba,  Canada.  Designed  by  Dr.  D.  A.  Stewart. 
.\dministratiox  Building,  \ie\v  of  Front  Elevation  and  Floor  Plans.  .\dxunistr.a.tive 
CAPACITY,  100  Patients.  Cost,  S33.000.  (See  illustration  Si  for  further  description  of  this  institu- 
tion.) 

59 


Section  II 


for  the  nurses  and  other  hcl]),  has  much  less  floor  area  than  the  first,  as  the  ceilino;  of  the 
dining  room  extends  above  its  le\cl.  The  building  has  an  administrative  capacity  for 
one  hundred  patients,  and  cost  $23,000,  but  this  does  not  include  the  laundry  and  heating 
plant,  which  are  housed  in  another  structure. 

Manitoba    Sanatorium    for    Consuniptives,    Ninktte,    Manitoba,    Canada, 

Administration  Building  (Illustration  25).  This  building  has  a  basement,  two  stories 
and  an  attic  lighted  by  dormer  windows.  It  is  88  feet  along  the  main  front  by  30  feet  wide 
and  has  a  rear  extension  34  feet  wide  by  36  feet  deep.  The  basement  walls  are  of  rough 
boulder  stone,  the  ground  floor  of  brick  veneer,  carried  on  a  steel  frame,  and  the  second 
and  third  stories  of  frame  construction,  finished  on  the  outside  with  stucco  upon  metal 
lath.  The  front  and  both  ends  of  the  building  are  considerably  broken  up  by  windows 
and  dons  and  are  flanked  by  a  porch  twelve  feet  wide.  The  basement  is  wholly  above  the 
ground  in  front  and  extends  out  as  far  as  the  edge  of  the  porch,  thus  making  it  twelve  feet 
deeper  than  the  upper  stories.  It  is  divided  into  a  main  dining-room  27  feet  wide  by  52 
feet  long,  a  kitchen  19  feet  wide  by  27  feet  long,  a  servants'  dining-room  12  feet  wide  by 
17  feet  long,  two  store  rooms  about  14  feet  wide  by  18  feet  long,  a  laundry  16  feet  wide 
by  29  feet  long,  an  ironing  room  14  feet  wide  by  28  feet  long  and  an  engine  room  containing 
the  steam  plant  for  heating  the  buildings. 

The  first  floor  is  divided  into  a  recreation  room  28  feet  wide  by  42  feet  long  and  two 
infirmary  wards  12  feet  wide  by  30  feet  long,  one  for  men  and  the  other  for  women,  two 
private  rooms  each  10  feet  wide  by  12  feet  long,  two  nurses'  rooms  12  feet  wide  by  12  feet 
long,  a  business  office  12  feet  wide  by  16  feet  long,  an  examining  room  12  feet  wide  by  15 
feet  long,  treatment  room  12  feet  wide  by  12  feet  long,  laboratory  8  feet  wide  by  12  feet 
long  and  lavatories,  toilets  and  closets. 

The  second  floor  is  cut  up  into  rooms  for  the  staff  and  nurses  and  the  third  floor 
for  servants'  quarters.  The  building  has  an  administrative  capacity  for  sixty  patients,  and 
cost  $33,000,  which  includes  its  proportion  of  the  funds  expended  in  heating,  plumbing, 
water  and  sewage  disposal  for  the  entire  plant.  The  pavilions  are  illustrated  under  the 
section  on  The  Lean-to  Type  of  Building. 

Indiana  State  Hospital,  Rockville,  Ind.,  Administration  Building  (Illus- 
tration 26 j.  This  structure  occupies  the  centre  of  a  group  of  buildings,  illustrated 
under  the  section  on  sites  and  grouping.  It  has  on  the  front  a  basement,  two  stories 
and  an  attic  under  a  mansard  roof;  in  the  rear  an  extension  of  only  one  story  and 
basement. 

The  main  portion  of  the  building  is  89  feet  along  the  front  and  52  feet  deep,  con- 
structed of  brick  on  a  stone  foundation.  The  front  basement  is  divided  by  a  long  corridor 
and  contains  two  storage  rooms  17  feet  wide  by  29  feet  long  with  cement  floors,  a  drug 
room  12  feet  wide  by  16  feet  long,  a  store  room  for  drugs  16  feet  wide  by  24  feet  long,  and 
a  servants'  sitting  room  17  feet  wide  by  31  feet  long,  connected  with  baths  and  toilets. 
The  basement  of  the  rear  extension  is  divided  into  two  large  storage  rooms,  a  washroom 
for  servants  and  a  preparation  room  for  vegetables. 

The  first  floor  has  a  large  reception  hall  in  the  centre  ^2  feet  wide  by  36  feet  long, 
running  from  the  front  to  the  rear  of  the  building.  On  one  side  is  an  office  1 7  feet  wide 
by  26  feet  long,  and  a  library  16  feet  wide  by  26  feet  long.  On  the  other  is  a  record  office 
15  feet  wide  by  25  feet  long  and  two  examination  rooms  12  feet  wide  by  12  feet  long.  At 
the  far  end  of  the  reception  hall  is  a  wide  stairway  to  the  upper  floors  with  a  staff  dining  hall 

bo 


Administration  Buildings 


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F'lKST     TuOOK    fUAn 


<5econD  Tlooe.  Pla/1. 


No.  26. — Indiana  State  Hospital,  Rockville,  Ind.     Rrubaker  &  Stern'.  Architects,     .\dmixistra- 

TIOX    BuiLDIXd.       \lE\V    OF    I'ROXT    Kl,E\  ATIOX    AXD    FlOOR  PlAXS.       AdMIXISTRATIVE    CAPACITY.   lOO 

Patients.     Estim.a.ted  Cost,  S50.000.     (See  illustrations  7,46  and  51  for  further  description  of  this 
institution.) 


61 


Section  II 

17  feet  wide  by  2g  feet  lon,^  on  one  side,  and  a  dental  room  15  feet  wide  by  16  feet  long, 
and  a  barber-shop  14  feet  wide  by  16  feet  long,  on  the  other.  At  the  rear  of  this  portion  of 
the  building  is  a  corridor  running  at  right  angles  to  the  reception  hall  and  leading  to  the 
patients'  pavilions  at  the  sides. 

Across  this  corridor  is  the  extension,  60  feet  deep  by  50  feet  wide,  one  story  high. 
It  contains  the  dining  hall  ()0  feet  wide  by  40  feet  deep;  a  well  lighted  and  ventilated 
room,  having  a  high  ceiling  and  provided  with  a  number  of  small  tables  each  seating 
eight  persons.  Behind  it  is  the  kitchen  and  pantry  containing  a  stairway  leading  to  the 
basement. 

The  second  and  third  floors  of  the  main  building  are  divided  into  apartments  for 
the  superintendent,  staff,  nurses  and  servants,  with  toilets,  closets,  baths  and  other  con- 
veniences in  each  stor}-.  It  has  an  administrative  capacity  for  one  hundred  patients  and 
the  estimated  cost  was  $40,000. 

The  Preventorium  for  Children,  Farmingdale,  N.  J.,  Administration  Build- 
ing (Illustration  27).  This  building  is  of  frame  construction,  with  a  shingle  roof,  excepting 
the  outside  walls,  which  are  of  hollow  tile,  covered  externally  with  cement  stucco  and 
placed  on  a  concrete  foundation.  The  floors  are  of  yellow  pine  and  all  the  corridors  and 
rooms  having  much  wear  are  covered  with  linoleum  held  in  place  by  brass  strips  laid  tlush 
with  the  flooring  material. 


SEECHffFLDOE  PLAn 


No.  27.     Preventorium  for  Children,  Farmingdale,  N.  J.     Scopes  &  Feustmann,  and  Walter  W. 

JlDEI.L,    ASSUCIATEU    AkcIII TKCTS.       .\UMIMSTRATIUX    Hi  ILUIXG.       FrOXT    AND  StoE    ELEVATIONS  .AND 

Floor  Plans.    Administration  Capacity,  112  Patients.     Cost,  $35,000.     (See  illustrations  12,  19 

and  Q5  for  further  fiescrii)ti<>n  of  this  institution.) 

62 


Administration  Buildings 


The  front  of  the  building  is  103  feet  long  by  36  feet  wide  and  the  rear  extension 
63  feet  long  by  27  feet  wide.  On  the  first  floor  in  the  main  section  is  a  business  office  12 
feet  long  by  18  feet  deep,  reception  room  12  feet  long  by  14  feet  deep,  staff  dining  room  17 
feet  long  by  20  feet  deep  and  a  doctor's  office  12  by  12  feet.  The  main  dining  room  occupies 
one-half  of  the  front  section  and  is  41  feet  long  by  31  feet  deep.  In  the  rear  extension  is 
a  ser\-ing  room  25  feet  wide  by  19  feet  deep,  kitchen  25  feet  long  by  19  feet  deep,  servants' 
dining  room  13  feet  wide  by  18  feet  deep,  and  cold  storage.  The  second  floor  is  divided 
in  both  sections  by  corridors.  On  the  front  is  an  apartment  consisting  of  two  rooms  and 
bath  for  the  medical  superintendent,  bedrooms  for  the  head  nurse  and  matron,  and  a 
staff  sitting  room.  On  the  rear  are  two  rooms  for  teachers,  a  sewing  and  linen  room,  a 
clerk's  room  and  twelve  rooms  and  a  bath  for  the  servants.  All  the  women  servants  are 
housed  in  the  administration  building,  and  the  men  in  the  third  floor  of  the  power  house. 

The  two  entrances  for  the  children  are  arranged  to  give  them  direct  access  to  the 
dining  room  without  going  through  other  parts  of  the  building. 

This  building  for  administrative  purposes  has  a  capacity  for  one  hundred  and 
twelve  children,  and  was  constructed  in  connection  with  a  reception  cottage  one  cjuarter 
mile  distant  which  is  a  separate  unit  and  has  a  capacity  for  thirty  children.  The  cost  of 
the  administration  building  was  $25,000. 


EXAMPLES  OF  SERVICE  BUILDINGS 

The  Municipal  Sanatorium,  Otisville,  New  York,  Service  Building  (Illus- 
tration 28).  This  was  planned  to  be  the  centre  of  a  group  of  lean-tos  and  cottages  at  an 
institution  made  up  of  a  number  of  separate  units;  each  to  house  about  one  hundred 
and  fifty  patients  and  all  to  be  administered  in  a  general  way  and  about  equidistant  from 
a  central  administration  building.  The  structure  illustrated  is  the  service  building  for 
the  first  men's  unit  and  contains  a  large,  commodious  dining  room,  kitchen,  two  sun 
parlors,  a  well  arranged  infirmary,  nurses'  and  servants'  quarters. 

It  is  placed  on  the  side  of  a  hill  where  the  drainage  is  good,  wdth  a  foundation  con- 
structed of  stone  which  extends  to  the  floors  of  the  first  story.  As  very  little  excavation 
was  necessary  in  the  front,  that  part  of  the  basement  is  mostly  above  the  ground,  well- 
lighted  and  gives  practically  an  extra  story.  This  is  used  as  a  bathing  apartment,  contain- 
ing a  variety  of  shower-baths  and  other  modern  bathing  fittings.  The  building  is  divided 
into  two  sections  connected  by  a  passageway  26  feet  wide  and  35  feet  long  in  which  the 
kitchen  and  serving  room  are  placed.  The  front  section,  116  feet  long  by  40  feet  wide, 
has  one  story  over  the  basement,  of  frame  construction,  covered  with  shingles.  It  is 
divided  into  a  large  dining  room  in  the  centre,  67  feet  long  by  24  feet  wide,  seating  from  120 
to  150  persons,  and  two  solaria  39  feet  long  by  25  feet  wide  for  reading  and  amusement 
purposes  connected  by  a  terrace  in  the  front  of  the  dining  room.  The  solaria  and  terrace 
are  enclosed  by  glass  and  sash  windows  which  can  be  and  usually  are  pushed  up  out  of  the 
way,  leaving  the  openings  entirely  clear. 

The  rear  of  the  building  is  for  all  practical  purposes  a  separate  structure  66  feet 
long  by  32  feet  wide,  and  as  the  hill  at  this  point  has  a  steep  slope,  the  floor  of  the  first 
story  is  close  to  the  ground  and  contains  the  storage,  work  rooms  and  other  apartments 
needed  by  the  service  staff.  The  second  floor  is  used  as  an  infirmary  and  is  divided  through 
the  centre  by  a  long  hall  four  feet  wide  which  opens  at  one  end  into  a  ward  27  feet  wide  by 
60  feet  long.     On  one  side  of  the  hall  is  a  two-bed  and  four  single-bed  rooms  and  a  locker 

63 


Section  11 


lEpi^llBiSiniuiaiaia 

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LJiJ'' """ niii.iiiiMiuiiiMiiiniiLiiii.inmiii 


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fl"l'!??   i    •     •    fit         g      Bf.-TIK-   1,1- 

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No.  28. — Municipal  Sanatorium,  Otisville,  N.  Y.  John  H.  \"ak  Pelt,  Architect.  Designs  of  the 
Department  of  Health.  Service  Building  and  Infirmary  for  One  Section  of  the  Institution. 
View  of  Front  and  Side  Elevation  and  Floor  Plans.  Service  Capacity,  250  Patients.  Esti- 
mated Cost,  $35,000.     (See  illustrations  14,  59,  60,  85,  94  and  loi  for  further  description  of  this 

institution.) 

64 


Administration  Buildings 


room.  On  the  other  is  one  two-bed  room,  a  stairway,  baths,  toilets  and  a  nurses'  room. 
These  are  surrounded  on  two  sides  by  large  open  \'erandas  upon  which  all  beds  can  be 
rolled  both  from  the  ward  and  the  private  rooms. 

The  third  story  under  a  slanting  roof  is  cut  up  into  two  dormitories,  four  single 
rooms,  toilets  and  closets  for  the  use  of  the  servant.^.  The  service  capacity  is  for  one 
hundred  and  fifty  patients  at  an  estimated  cost  for  construction  of  835,000. 

Iowa  State  Sanatorium,  Oakdale,  la.,  Service  Cottage  (Illustration  29). 
This  building  was  erected  to  provide  a  kitchen  and  dining  room  for  an  infirmary  group 
consisting  of  three  cottages  all  connected  by  a  covered  corridor  and  built  on  the  lines  of 


«?» 


No.  29. — Iowa  State  Sanatorium,  Oakdale,  la.  Designed  by  Dr.  H.  E.  Kirschner.  H.  F.  Liebbe, 
Architect.  Service  Building  for  Infirmary  Group  of  Cottages.  \'iew  of  Front  Ele\atiox 
AND  Floor  Plans.  Service  Capacity,  20  Patients.  Estim.ated  Cost,  So.ooo.  (See  illustrations 
24,  84  and  103  for  further  description  of  this  institution.) 

5  65 


Section  II 


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30. — Catawba  Sanatorium,  Catawba,  Va.  Designed  by  Dr.  Exxion  c;.  \\ili,ia.\is.  Service 
BuiLDixG,  CoxTAixiXG  AX  Amusemext  Hall.  Froxt  Ei.kvatiox  axd  Floor  Plax.  Ser\ice 
Capacity,  70  Patiexts.  Estimated  Cost,  $10,000.  (See  illustrations  17,  69  and  So  for  further 
description  of  thi';  institution.) 


the  incipient  patients'  cottages  at  the  Iowa  State  Sanatorium  iUustrated  in  the  section  on 
The  Cottage  Type  of  Building.  It  is  of  frame  construction  on  a  stone  foundation  with 
two  stories  and  a  cellar.  The  first  floor  is  divided  into  three  rooms,  a  large  kitchen  in 
the  rear  21  feet  wide  by  13  feet  deep,  with  a  small  pantry,  refrigerator  and  cupboards 
back  of  it,  and  two  dining  rooms  12  feet  wide  by  18  feet  deep  on  the  front,  di\ided  by  a 
stairway  leading  to  the  upper  story.  This  floor  has  a  porch  1 1  feet  wide  by  53  feet  long 
across  the  front  with  an  e.xtension  fifteen  feet  deep  to  the  rear  on  each  side  of  the  build- 
ing and  of  the  same  width. 

The  second  floor  is  divided  into  four  bedrooms  for  ser\-ants,  al!  8  feet  6  inches  wide 
by  12  feet  6  inches  long,  a  toilet  and  l)ath  8  feet  widt'  by  11  feet  long  and  a  sleeping  porch 

60 


Administration  Buildings 


or  loggia  S  Icct  wide  by  29  feet  long,  which  is  part  of  the  main  structure,  being  placed 
back  under  the  roof  of  the  l)uilding. 

The  service  cottage  is  unusual  and  interesting  because  of  the  wide  extent  of  its 
porches  and  the  simplicity  of  its  floor  plans,  with  a  capacity  for  20  patients,  at  a  low  cost 
estimated  at  S5,ooo. 


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No.  31.— New  Haven  County  State  Tuberculosis  Sanatorium,  Meriden,  Conn.  Foote  &  Towxsexd, 
Architects.  Serxice  Building,  \ie\v  of  Front  Elevation  .\nd  Floor  Plans.  Ser\ice 
Capacity,  122  Patients.  Estimated  Cost,  815.000.  (See  illustration  79  for  further  description  of 
this  institution.) 

67 


Section  II 


Catawba  Sanatorium,  Catawba,  Va.,  Service  Building  (Illustration  30). 
This  building  is  of  frame  construction,  raised  on  stone  i)iers.  It  is  108  feet  long  by  54  feet 
wide,  with  a  rear  extension  30  feet  wide  i)y  30  feet  deep  and  a  porch  eight  feet  wide  on  the 
front  and  sides.  It  is  divided  into  two  dining  rooms  27  feet  wide  by  40  feet  deep  at  the 
ends  of  the  building  and  a  large  amusement  hall  54  feet  wide  by  27  feet  deep  between  them 
in  the  centre.  This  hall  has  a  large  fire-place  and  can  be  thrown  open  in  connection  with 
the  two  dining  rooms  by  raising  windows  in  the  walls  between  them.  The  building  has 
six  entrances  on  the  veranda  and  the  front  and  sides  are  well  broken  up  by  windows  in 
order  to  give  the  patients  open  air  dining  and  sitting  rooms.  Directly  behind  the  hall  is 
the  kitchen  27  feet  wide  by  37  feet  deep,  housed  partly  under  the  main  roof  and  partly 
in  the  rear  extension.  The  kitchen  is  connected  to  each  dining  room  by  pantries  or  serving 
rooms  13  feet  wide  by  13  feet  deep  and  has  in  the  rear  a  bakery  13  feet  wide  by  iS  feet 
deep,  a  store  room  21  feet  wide  by  13  feet  deep,  and  a  refrigerator. 

This  plan  for  a  service  building  is  to  be  commended  and  well  illustrates  the  reasons 
for  constructing  a  separate  structure  to  house  this  department,  as  it  provides  under  a  roof 
open  air  dining  rooms,  with  cross-ventilation  and  light  from  every  direction.  It  has  a 
service  capacity  for  seventy  patients  at  an  estimated  cost  of  $10,000. 

New  Haven  County  Tuberculosis  Sanatorium,  Meriden,  Conn.  (Illustration 
31).  This  building  is  one  story  with  a  cellar,  of  frame  construction,  on  a  stone  foundation. 
It  is  constructed  in  two  sections,  the  front  being  53  feet  wide  by  26  feet  deep.  The  cellar 
extends  under  the  entire  building  with  a  floor  laid  in  cement  and  is  used  for  storage  with 
the  exception  of  a  room  where  the  heating  plant  is  installed.  The  dining  room  occupies 
the  entire  front  of  the  building  and  is  52  feet  wide  by  25  feet  deep.  It  is  entered  through 
a  vestibule  from  a  porch  S  feet  wide  by  22  feet  long  and  is  furnished  with  twelve  tables, 
seating  ninety-six  persons.  The  room  is  well  lighted  and  ventilated,  but  is  not  an  open 
air  pavilion.  At  its  rear  in  the  extension  is  a  serving  room  25  feet  wide  by  15  feet  deep, 
and  behind  this  the  kitchen  25  feet  wide  by  30  feet  deep,  furnished  with  a  large  refrigerator, 
a  small  toilet,  dumb-waiter  to  the  storage  rooms  below  and  connected  with  the  cellar  by 
stairs,  which  leads  to  a  cold  storage  plant.  It  has  a  service  capacity  for  one  hundred 
and  twenty-two  patients  at  an  estimated  cost  of  $20,000. 


68 


SECTION  III 


Administration   Buildings   and   Patients' 
Quarters  Combined 


SECTION  III 
Administration  Buildings  and  Patients'  Quarters  Combined 


The  Need  for  Combination  Buildings 

The  rapid  growth  of  pubUc  opinion  in  regard  to  the  necessity  of  caring  for  and 
isolating  the  advanced  tuberculosis  patient  and  the  growing  belief  that  the  spread  of  this 
disease  cannot  he  checked  without  the  removal  of  advanced  cases  from  the  homes  of  the 
poor  and  ignorant,  has  caused  a  continually  increasing  number  of  hospitals  to  be  constructed 
during  the  past  two  years,  designed  to  house  the  entire  institution  under  one  roof.  It  is 
claimed  for  this  style  of  building  that  it  is  possible  to  economize  on  the  installation  of  the 
plumbing,  heating,  and  administrative  arrangements,  that  it  concentrates  the  work,  and 
is  particularly  good  for  city  use,  where  property  is  valuable  and  a  site  cannot  be  obtained 
at  a  reasonable  cost  for  the  erection  of  the  pavilion  type  of  hospital,  or  one-story  lean-tos 
and  cottages  spread  over  a  large  area  of  ground. 

These  buildings  may  be  used  for  housing  either  incipient  or  advanced  cases  of 
tuberculosis,  and  are  planned  and  constructed  on  lines  conforming  in  many  ways  to  the 
needs  of  a  general  hospital.  As  they  are  intended  usually  for  the  service  of  small  com- 
munities and  are  often  placed  on  the  outskirts  or  within  towns  or  cities  the  site  selected 
should  be  near  the  line  of  an  electric  car  system,  with  enough  land  to  allow  of  the  free 
circulation  of  air  on  all  sides  of  the  building.  Two  entrances  should  be  provided  when 
possible,  one  for  the  staff,  patients  and  their  friends,  and  the  other  for  merchandise  and 
service. 

Planning  Combination  Buildings 

In  designing  these  buildings  there  should  be  provided  for  all  advanced  cases,  single 
bedrooms  or  rooms  with  not  more  than  two  beds  in  each,  and  for  incipient  cases  small 
wards  of  not  more  than  six  patients  or  rooms  for  two  patients  each.  Every  patient  housed 
under  the  main  roof  should  have  two  thousand  cubic  feet  of  air  space  and  a  porch  area 
eight  feet  wide  by  ten  feet  deep,  or  at  least  large  enough  for  a  bed,  reclining  chair  and  table. 

As  fire  protection  is  compulsory  in  many  cities  it  is  suggested  that  reinforced 
concrete,  brick,  terra  cotta  or  concrete  tile  construction  with  reinforced  concrete  floors 
be  adopted,  as  buildings  erected  in  this  manner  are  practically  non-combustible.  The 
structure  should  be  wired  for  bells  or  telephonic  communication  when  it  is  wiretl  for  lighting, 
as  bell  calls  or  telephones  should  be  installed  in  all  rooms  to  he  used  l)y  patients.  The 
walls  and  ceilings  should  be  finished  in  hard  plaster,  painted  and  varnished.  The  corners 
in  the  wall  angles  and  at  the  ceiling  and  floor  should  be  rounded.  Light  colors  may  be 
used  on  the  walls  instead  of  a  dead  white;  in  fact,  a  harmonious  color  scheme  throughout 
the  entire  building  is  an  advantage,  as  it  is  one  of  the  means  for  making  patients  haj^py 
and  contented.  A  ventilating  system  is  not  necessary  in  these  buildings,  but  all  the  wall 
space  possible  should  be  used  for  windows.     The  floors  of  the  interior,  except  the  toilets. 


Administration  Buildings  and  Patients'  Quarters  Combined 


No.  32. — Eastern  Maine  Hospital,  Bangor,  Me.     T.  C.  &  J.  H.  Stex^exs,  Architects.     Illustratixg 

A  Method  of  Prdtectixc;  a  Sleeping  Porch  with  Hea\v  Wire  Nettixg.     Useful  whex  a 

Porch  Faces  a  Street  or  to  Pre\ext  Patients  from  Lea\ixg  wtthoct  Permissiox. 


No.  33. — United  States  Hospital  for  the  Insane,  Washington,  D.  C.     Showing  a  Method  of  Inclosing 

A  Sleeping  I'kkc  h  with  Swinging  Sash  Frames;   Usefcl  for  City  Hospitals  with  Porches 

Having  X'ariois  Fxposures. 


71 


Section  III 


72 


Administration  Buildings  and  Patients'  Quarters  Combined 

baths,  laundry  and  kitchen,  should  be  of  hard  wood,  treated  by  oil  and  wax,  or  ordinary 
narrow  board  floors,  covered  with  battle-ship  linoleum.  Other  floors  which  come  in  contact 
with  an  unusual  amount  of  water  should  be  of  terrazzo,  cement,  tile,  or  of  one  of  the 
patent  composition  floorings.  All  the  doors  and  passageways  should  be  wide  enough 
for  the  easy  rolling  of  the  beds  through  them ;  that  is,  not  less  than  three  feet  si.x  inches. 
There  should  be  no  door  sills  or  panels  in  the  doors;  and  all  the  interior  finish  around 
them  and  the  windows  should  be  placed  flush  so  as  not  to  produce  projections  or  corners 
which  will  catch  the  dust.  The  building  should  be  constructed  on  the  sanitary  principles 
laid  down  for  general  hospitals,  and  the  rooms  for  advanced  cases  and  all  the  porches 
screened  with  wire  netting  which  can  be  removed  during  the  cold  weather. 

The  examples  of  Iniilding  and  floor  plans  given  are  not  all  model  arrangements,  but 
each  one  ofifers  some  suggestions,  not  found  in  the  others,  which  may  be  of  use  to  designers 
of  this  class  of  institutions. 


Rooms  for  Administrative  Purposes 

The  building  should  contain  for  administrative  purposes  the  following  rooms: 


Dining  Room  for  Patients 

Dining  Room  for  Staff 

Dining  Room  for  Servants 

Kitchen 

Diet  Kitchens 

Bakery 

Serving  Room 

Dish  Closet 

Cold  Storage 

Physician's  Office 

Special  Treatment  Room 

Waiting  Room 

Laboratory 

Drug  Room 

Business  Of^ce 

Sitting  Room 

Library 


Superintendent's  Quarters 

Physician's  Quarters 

Nurses'  Quarters 

Servants'  Quarters 

Sewing  Room 

Linen  Room 

Store  Rooms 

Sink  Rooms 

Bath  Rooms 

Toilets 

Laundry 

Disinfecting  Room 

Crematory 

Morgue 

Autopsy  Room 

Heating  Plant 

Workshop 

Coal  Storage 


EXAMPLES  OF  CO:\IBINATION  BUILDINGS 

Sharon  Sanatorium,  Sharon,  Mass.  (Illustration  34).  This  is  one  of  the  oldest 
buildings  in  America  constructed  for  the  open  air  treatment  of  tuberculosis  and  was 
planned  to  be  an  administration  building  and  patients'  quarters  combined.  Its  con- 
tinuous use  for  fifteen  years  has  demonstrated  its  convenience  for  housing  incipient 
and  moderately  advanced  cases.  Any  one  planning  to  build  a  sanatorium  and  desir- 
ing to  have  a  complete  unit  under  one  roof,  particularly  if  there  is  a  farm  house  or  country 
residence  on  the  site  selected,  will  find  this  a  convenient  design  to  adopt,  as  the  orig- 
inal structure  can  be  used  for  administrative  purposes  and  an  extension  added  on  one  or 
both  sides  for  patients'  quarters.  By  using  this  method  it  is  possible  to  build  a  compara- 
tively cheap  sanatorium  if  the  patients'  quarters  are  constructed  in  an  economical  way. 
The  extension  in  the  illustration  runs  from  the  dining-room  and  includes  the  sun  parlor, 
with  the  toilets,  baths,  and  closets,  in  the  rear  of  the  hall.     The  sleeping  porch  is  wide 

73 


Section  111 


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74 


Administration  Buildings  and  Patients'  Quarters  Combined 


No.  36.— Tuberculosis  Hospital,  Washington,  D.  C.     Dkskined  by  Dr.  George  :M.  Kober.     Frank 
JVlu-Es  Day  &  Brother,  .Vrchitects,     Floor  Plans.     Capacity,  120  Patients.    Co.st,  Sioo.ooo. 


/:> 


Section  III 


enough  to  give  plent}-  of  room  for  the  patients  to  move  around  at  the  sides  of  the  beds, 
and  is  protected,  when  necessary,  from  the  sun  and  rain  by  a  canvas  awning  which  can  be 
rolled  up  out  of  the  way,  leaving  the  porch  uncovered.  The  doors  from  the  private  rooms 
opening  on  the  j^orch  are  made  wide  enough  for  the  beds  to  pass  through  them. 

It  is  suggested  that  an  improvement  to  this  building  can  be  made  by  putting  in 
Dutch  doors  below  all  windows  opening  on  the  porches  and  by  placing  a  glass  roof  under 
the  canvas  curtain  which  protects  and  covers  the  sleeping  balconies,  as  such  a  roof  would 
not  shut  out  the  light  from  the  rooms  when  the  curtains  are  drawn  back  and  would  be 
more  durable  than  canvas  alone.  Also,  that  the  bedrooms  opening  on  the  porches  can 
be  constructed  of  a  smaller  calibre,  as  the  beds  are  chiefly  out  of  doors  and  the  rooms  are 
used  merely  for  dressing.  The  building  has  a  capacity  for  twenty-five  patients.  The 
estimated  cost  was  $45,000. 


The  Tuberculosis  Hospital,  Washington,  D.  C.  (Illustrations,  35  and  36).  This 
hospital  was  built  at  a  remarkably  low  cost,  and  is  interesting  in  the  way  it  is  planned  to 
house  advanced  and  incipient,  white  and  colored,  male  and  female  patients;  each  group 
in  a  separate  wing  or  on  a  different  floor.  The  hospital  is  planned  to  provide 
accommodations  in  separate  wards  on  the  first  floor  for  white  and  colored  males 
who  are  in  the  later  stages  of  the  disease;  and  the  second  floor  is  arranged  in  the  same 
manner  for  white  and  colored  females.  The  incipient  cases  of  both  sexes,  white  and 
colored,  are  housed  in  open-air  wards  on  the  third  and  fourth  floors.  These  open  wards 
are  roof  gardens  with  casement  windows  on  the  north,  but  are  entirely  open  on  the  east, 
south  and  west  sides. 

A  careful  study  of  the  arrangement  of  the  wards,  noting  the  allotment  of  floor  space 
to  the  dift'erent  classes  of  patients,  is  interesting.  The  length  of  the  building  along  the 
front  is  two  hundred  and  ten  feet  by  twenty-five  feet  wide  through  the  wards,  and  fifty 
feet  through  the  centre.  The  side  extensions  are  eighty-two  feet  long  and  the  rear  extension 
on  the  upper  floors  is  fifty  feet  long,  but  as  it  runs  into  the  side  hill  it  has  not  been  excavated 
the  entire  length  in  the  basement.  The  basement  contains  a  large  dining  room,  kitchen, 
store  rooms,  boiler  rooms,  refrigerator,  postmortem  room,  and  morgue. 

The  arrangement  of  the  first  and  second  floors  is  the  same,  the  side  wards  being  48 
feet  long  by  25  feet  wide,  the  sun  parlors  25  feet  deep  by  14  feet  wide,  and  the  rest  of 
the  floor  space  divided  into  rooms  for  offices,  toilets,  diet  kitchen,  and  the  other  accessories 
used  in  a  general  hospital. 

The  wings  and  extension  on  the  third  floor  are  used  as  three  large  open-air 
wards,  two  71  feet  long  by  24  feet  wide,  and  one  57  feet  long  by  25  feet  wide. 
The  centre  of  the  building  on  this  floor  is  divided  in  much  the  same  manner  as 
the  lower  stories,  but  the  rooms  are  used  as  toilets  and  baths  for  the  patients  and 
as  apartments  for  the  nurses.  Over  the  main  part  of  the  building  on  the  fourth  floor 
is  an  open-air  ward,  28  feet  wide  by  44  feet  long,  with  toilets,  baths,  and  dressing  rooms 
opening  into  it  from  the  rear. 

The  building  is  a  substantial  brick  structure,  well  finished  on  the  interior  in  hard 
wood,  gi\'ing  a  good  substantial  appearance,  and  there  is  a  commodious  electric  elevator. 
The  institution  is  well  worth  a  visit,  not  only  because  of  its  unique  arrangement,  but 
also  because  it  will  offer  many  suggestions  to  those  who  ha\"e  to  solve  the  problem  of 
housing  tuberculous  patients  in  large,  congested  cities.  It  has  a  capacity  of  one  hundred 
and  twenty  beds,  and  cost  to  erect  and  furnish,  Siocooo. 

76 


Administration  Buildings  and  Patients'  Quarters  Combined 


T,I 


lUKHlUCK  i     j,i  ;i  \_JL 


HLAN' 


[ 


No.  37.^Lady  Grey  Hospital,  Ottawa,  Canada.     Weeks  &  Keeper,  Architects.     View  of  Front 
Elevatio.\  and  Fl();)r  Plans.     Capacity,  45  Patients.     Co.st,  S6o,ooo. 

77 


Section  111 


The  Lady  Grey  Hospital,  Ottawa,  Canada  (Illustration  37).  This  l)uilding 
was  erected  by  the  Ottawa  Anti-tuberculosis  Association  and  furnished  by  the  Daughters 
of  the  Empire,  then  handed  over  as  a  gift  for  the  people  to  be  maintained  by  the  city. 
It  is  situated  within  the  western  limits  of  Ottawa  on  an  elevated  site,  with  sloping  ground 
beside  a  beautiful  grove  of  mature  maples  forming  a  little  park  with  seats  and  hammocks 
in  the  shade  for  the  patients  during  the  hot  days  of  summer. 

The  building  is  a  three  story  structure  with  a  large  basement  constructed  of  hard 
local  red  brick,  laid  in  white  mortar,  on  a  concrete  foundation,  with  Indiana  limestone 
trimmings,  following  closely  the  modern  English  residential  style  of  architecture.  It  faces 
southwest  and  has  a  number  of  large  verandas  screened  by  wire  against  insects,  which 
open  into  the  different  wards  by  wide  doors  through  which  the  beds  are  wheeled. 
The  main  front  of  the  building  is  130  feet  long  by  45  feet  wide,  and  the  rear  extension 
is  41  feet  deep  by  21  feet  wide. 

The  basement  contains  a  laundry  12  feet  wide  by  20  feet  deep,  drying  room 
10  feet  wide  by  8  feet  deep,  laboratory  12  feet  wide  by  14  feet  deep,  storage  for 
furnace  coal  20  feet  wide  by  12  feet  deep,  furnace  room  for  two  boilers  for  the 
heating  plant  12  feet  wide  by  20  feet  deep,  and  a  room  for  elevator  machinery  6  feet 
wide  by  8  feet  deep. 

The  main  portion  of  the  first  floor  is  divided  through  its  entire  length  by  a  corridor 
eight  feet  six  inches  wide,  having  on  the  front  a  veranda  72  feet  long  by  12  feet  wide.  Be- 
tween the  veranda  and  the  corridor  are  six  single  rooms  10  feet  wide  by  12  feet  deep  and 
at  each  end  of  the  corridor  on  the  front  are  two  wards  of  the  same  size  18  feet  wide  by  18 
feet  deep,  for  three  patients  each,  with  a  small  veranda  extending  out  from  them  at  the 
sides  of  the  building,  the  one  on  the  right  being  8  feet  wide  by  22  feet  long  and  the  one  on 
the  left  10  feet  wide  by  14  feet  long. 

The  entrance  hp.U  is  in  the  centre  of  the  building  14  feet  wide  by  15  feet 
deep,  with  the  main  stairway  leading  up  on  one  side  and  a  locker  room  on  the  other. 
On  the  rear  of  the  corridor  is  the  patients'  dining-room  22  feet  wide  by  20  feet  deep, 
a  doctor's  office  10  feet  wide  by  14  feet  deep,  an  examination  room  6  feet  wide  by  8  feet 
deep,  a  parlor  16  feet  wide  by  12  feet  deep,  a  nurses'  room  10  feet  wide  by  14  feet 
deep,  and  toilets  and  baths  for  both  men  and  women.  In  the  rear  extension  on  the 
right  of  the  building,  back  of  the  dining-room,  is  a  kitchen  22  feet  wide  by  14  feet  deep, 
servants'  dining-room  10  feet  wide  by  10  feet  deep,  serving  room,  pantry,  refrigerator  room 
and  store  rooms. 

The  second  floor  is  arranged  in  the  same  way  as  the  first,  with  verandas  on  the  front 
and  sides  of  the  same  dimensions,  six  single  rooms  and  two  wards  in  front  of  a  corridor 
running  the  entire  length  of  the  building,  and  in  its  rear  a  large  ward  o\-er  the  dining 
room  22  feet  wide  by  20  feet  deep,  toilet  and  baths  for  women  and  men,  a  matron's  room 
14  feet  wide  by  18  feet  deep,  two  nurses'  rooms  14  feet  wide  by  12  feet  deep,  and  a  locker 
room  for  patients.  In  the  extension  is  a  diet  kitchen  9  feet  wide  by  6  feet  deep,  a  nurses' 
dining  room  14  feet  wide  by  13  feet  deep,  a  nurses'  sitting  room  21  feet  wide  by  21  feet 
deep,  and  a  small  hall  three  feet  wide,  running  into  the  main  corridor  at  a  right  angle. 

The  third  floor  also  has  the  same  general  arrangement  planned  for  the  lower  floors, 
except  that  there  are  no  side  verandas  and  the  extension  is  divided  into  bedrooms  and  a 
toilet  for  the  servants.  The  building  has  a  capacity  for  forty-five  patients,  is  heated  by 
steam,  has  an  elevator  and  dumb  waiters,  and  cost  S6o,ooo. 

7S 


Administration  Buildings  and  Patients'  Quarters  Combined 


TlR-S-T    rLClCt.   P— \N 


5i:rOND   fLOOE  ^L>^N 


No.  38.     Lake  Edward  Sanatorium,  Lake  Edward,  Province  of  Quebec,  Canada.     Scopes  &  Fiasx- 

MANX,    .\R(  IlITl.CTS.       X'iKW    OV    FkoXT  AND   SlOK    I'',I.|;\  ATU  IN .  Fl.i )( IR    PlANS. 

Caiwcitv,  2b  Patikxts.     Cost,  $2(1.000. 


Lake   Edward   Sanatorium,   Lake   Edward,   Province   of   Quebec,   Canada 

(Illustration  ^S).  This  buildins;  is  placed  on  a  stone  foundation  two  feet  thick,  and  is 
of  frame  construction,  with  a  shingled  exterior.  In  order  to  protect  the  interior  from  cold 
as  much  as  possible  the  walls  are  constructed  in  layers  from  the  outside  in,  as  follows: 
shingles,  paper,  siding,  paper,  siding,  studs,  wooden  lath,  plaster.  The  floors  are  hard 
wood  throughout.  All  patients  are  provided  with  porch  space  and  can  be  wheeled  from 
their  rooms  to  the  \eranda  assigned  to  them. 

The  building  is  87  feet  long  by  25  feet  wide,  with  two  extensions  in  the  rear,  one 
28  feet  wide  by  19  feet  dee]),  and  the  other  2S  feet  wide  by  54  feet  deep;  each  porch 
was  designed  as  a  loggia,  and  is  a  part  of  the  structure  under  the  main  roof. 

79 


Section  III 


The  first  floor  of  the  main  section  is  divided  as  follows:  Beginning  on  the 
left  of  the  illustration,  first  a  loggia,  called  the  west  porch,  19  feet  wide  by  10  feet  deep, 
then  a  patients'  room  g  feet  wide  by  12  feet  deep,  an  oflfice  9  feet  wide  by  12  feet  deep,  a 
living  room  23  feet  wide  by  1 2  feet  deep  (from  which  extends  in  front  a  loggia  or  the  south 
porch  24  feet  wide  by  11  feet  deep),  a  drug-room  9  feet  wide  by  12  feet  deep,  a  medical 
office  9  feet  wide  by  12  feet  deep,  and  a  loggia  (the  east  porch)  19  feet  wide  by  10  feet  deep. 
At  the  rear  of  these  apartments  is  a  corridor  six  feet  wide,  connecting  the  two  corner  porches 
and  behind  it  is  the  main  entrance  and  stairway  to  the  second  floor,  a  men's  toilet  9  feet 
wide  by  4  feet  deep,  and  two  alcoves  9  feet  wide  by  4  feet  deep. 

On  the  west  end  of  the  building  in  the  rear  is  the  smaller  extension,  divided  down 
the  centre  by  a  hall  four  feet  wide,  opening  into  the  main  corridor.  On  one  side  of  the 
passage  are  two  patients'  rooms,  one  10  feet  wide  by  12  feet  deep,  the  other  9  feet  wide 
by  12  feet  deep,  and  a  linen  room.  On  the  other  side  is  a  coat  room  9  feet  wide  by  7  feet 
deep,  a  bath  room  5  feet  wide  by  10  feet  deep,  a  locker  room  5  feet  wide  by  10  feet  deep, 
and  the  toilet  room  for  women  5  feet  wide  by  8  feet  deep. 

In  the  extension  on  the  east  of  the  building  is  a  dining-room  14  feet  wide  by  23 
feet  long,  a  pantry  11  feet  wide  by  15  feet  long,  a  kitchen  15  feet  wide  by  18  feet  long,  a 
servants'  loggia  or  porch  7  feet  deep  by  14  feet  wide,  a  servants'  sitting  room  10  feet  wide 
by  14  feet  long,  the  service  and  cellar  stairway,  refrigerator  and  store  room. 

On  the  second  floor  the  building  is  divided  by  a  corridor  practically  in  the  same 
way  as  on  the  first,  with  six  rooms  each  9  feet  wide  by  1 2  feet  deep,  on  the  front  for  patients, 
and  an  east,  west  and  south  loggia  of  the  same  dimensions  as  those  on  the  first  floor, 
the  south  porch  being  reached  by  a  small  hall  four  feet  wide,  in  the  centre  of  the  building. 
In  the  rear  of  the  corridor  is  a  small  loggia  on  one  side  of  the  main  stairway  and  a  coat 
room  on  the  other.  The  west  extension  is  divided  into  a  bedroom  and  sitting  room  for 
the  superintendent,  a  nurses'  sleeping  room,  closets,  toilets,  baths  and  a  linen  cupboard. 
The  east  extension  is  divided  down  the  centre  by  a  hall  opening  into  the  main  corridor 
with  two  rooms  for  patients,  a  store  room,  maid's  room  and  a  refrigerator  room  on  one  side, 
and  a  pantry,  lockers,  baths  and  two  maids'  rooms  on  the  other. 

The  third  floor  has  also  the  same  general  arrangement.  Six  single  rooms  for  patients 
on  the  front  with  a  corridor  in  their  rear,  an  east,  west  and  south  loggia,  all  somewhat 
smaller  than  those  on  the  floors  below,  two  rooms  for  patients  in  the  west  and  five 
in  the  east  extension,  together  with  baths,  toilets,  and  lockers,  placed  at  convenient 
points. 

The  building  is  a  complete  institution  in  itself,  supplying  each  patient  with  an  in- 
dividual room.  There  is  a  heating  plant  in  the  cellar,  and  electricity  is  generated  for 
lighting  purposes  on  the  premises.  The  capacity  is  twenty-six  beds,  housing  all  classes  of 
patients,  at  a  cost  for  construction  of  $26,000,  or  $1,000  per  patient. 

Franklin  County  Tuberculosis  Hospital,  Columbus,  Ohio  (Illustration  39). 
This  building  is  constructed  of  brick  on  a  stone  foundation,  in  one  long  block  with  two 
small  rear  extensions.  It  is  two  stories  high  and  has  a  basement  under  the  entire  building? 
and  a  third  story  over  the  centre.  The  building  is  one  hundred  and  ninety-six  feet 
along  the  front  and  for  convenience  of  description  can  be  divided  into  five  sections:  the 
centre  or  administration  block  is  60  feet  long  by  41  feet  wide,  the  sections  on  each  side, 
including  the  extensions,  are  28  feet  wide  by  60  feet  deep,  and  beyond  these  are  ward  sec- 
tions 40  feet  long  by  32  feet  wide.  The  general  plan  of  each  floor  is  ahke  in  the  centre 
of  the  building,  with  rooms  in  the  front  and  back  divided  by  a  corridor  which  ends  in  wards. 

80 


Administration  Buildings  and  Patients'  Quarters  Combined 


No.  39.— Franklin  County  Tuberculosis  Hospital,  Columbus,  Ohio.     Howard  &  Merriam,  Archi- 
tects.    Front  Ele\atiox  and  Floor  Plans.     C.ap.a.citv,  100  I'atients.     Estixlated  Cost,  SSo.ooo. 

6  81 


Section  III 


The  central  block  contains  in  the  basement,  on  the  front  a  chapel  i6  feet  wide  by 
i8  feet  deep,  a  morgue  lo  feet  wide  by  i8  feet,  receiving  room  in  connection  with  the  morgue 
23  feet  wide  by  18  feet  deep,  and  the  elevator  shaft;  on  the  rear  a  drying  room  23  feet 
wide  by  12  feet  deep,  a  stairway,  toilets,  and  a  storage  room. 

The  tirst  floor  is  divided  in  the  centre  by  the  entrance  hall  ten  feet  wide,  which 
opens  at  right  angles  into  the  main  corridor,  with  the  stairway  to  the  upper  stories  opposite 
the  door.  On  the  front  are  the  public  offices,  doctor's  office,  and  examining  rooms.  On 
the  rear  are  four  pri\"ate  rooms  and  two  locker  rooms. 

The  second  floor  is  devoted  to  the  children's  department.  Over  the  executive 
offices  in  the  front  are  two  wards  23  feet  wide  by  18  feet  deep,  one  for  girls,  the  other 
for  boys.  Opposite  on  the  rear  are  the  locker  rooms,  linen  rooms  and  toilet  rooms  in  con- 
nection with  them. 

The  extension  sections  are  also  divided  by  the  corridor  which  runs  through  the 
central  block  and  that  portion  of  them  not  under  the  main  roof  is  twenty-four  feet  deep 
by  twenty  feet  wide.  In  the  basement  on  one  side  in  the  rear  is  the  laundry,  and  on  the 
other  the  kitchen,  both  22  feet  deep  by  17  feet  wide.  In  the  front  are  the  service  stair- 
ways, janitor's  department,  machinery  room  and  a  sterilizing  room.  On  the  first  and 
second  floors  are  the  toilets  and  baths,  private  rooms  and  diet  kitchens.  On  the  third 
floor  in  the  rear  are  two  wards,  17  feet  wide  by  22  feet  deep,  one  for  men  and  the  other 
for  women.     In  the  front  are  the  toilets  and  baths  and  linen  rooms. 

The  ward  sections,  20  feet  wide  by  39  feet  long,  are  not  used  in  the  basement,  but 
on  the  first  and  a  second  floors  are  alike,  having  in  front  an  enclosed  porch  or  solarium 
9  feet  wide  by  39  feet  long. 

This  building  is-  intended  for  all  classes  of  cases  and  is  designed  to  bring  under  one 
roof  an  entire  plant  with  a  capacity  of  one  hundred  patients  at  a  cost  of  $80,000. 

County  Tuberculosis  Sanatorium,  Hartford,  Conn.  (Illustration  40).  This  is 
a  small  building,  consisting  of  a  remodeled  farmhouse  used  for  administration  purposes 
to  which  has  been  added  a  rear  extension  for  housing  the  patients.  The  building  is  of 
frame  construction,  two  stories  high,  the  original  structure  being  40  feet  wide  by  36  feet 
deep  and  the  extension  93  feet  long  by  28  feet  wide,  including  the  veranda.  There  is  a 
cellar  under  the  main  building  but  no  excavation  under  the  extension  except  for  a  tunnel 
carrying  the  steam  pipes  from  the  cellar  in  the  administration  building  to  the  dressing  and 
toilet  rooms. 

The  first  floor  of  the  administration  section  is  divided  into  a  reception  room  15 
feet  wide  by  12  feet  deep,  an  entrance  hall  11  feet  wide  by  12  feet  deep  and  an  office  12 
feet  wide  by  12  feet  deep.  At  the  rear  of  these  rooms  is  a  dining  room  14  feet  wide  by 
23  feet  long  and  a  kitchen  12  feet  wide  by  15  feet  long,  connected  with  a  serving  room, 
pantry,  closet  and  stairway  to  the  cellar.  On  this  floor  a  passageway  three  feet  wide  con- 
nects the  dining  room  with  the  patients'  quarters  which  are  di\ided  into  four  single 
rooms  7  feet  wide  by  8  feet  deep  and  a  ward  48  feet  long  by  14  feet  deep  cut  up  into  six 
cubicles  eight  feet  wide.  This  ward  opens  on  to  a  veranda  twelve  feet  wide  and  into  a 
dressing  room  at  the  far  end  of  the  extension  16  feet  wide  by  26  feet  deep,  containing 
toilets,  baths  and  lockers. 

The  second  floor  of  the  administration  section  is  divided  into  four  bedrooms,  two 
12  feet  wide  by  15  feet  long,  one  9  feet  wide  by  16  feet  long  and  one  11  feet  wide  by  12 
feet  long,  a  stairway  and  a  hall  connecting  it  with  the  extension.  This  floor  of  the  patients' 
quarters  is  arranged  in  the  same  manner  as  the  first  floor,  with  the  exception  of  the  addition 

82 


Administration  Buildings  and  Patients'  Quarters  Combined 


No.  40.— Hartford  County  State  Tuberculosis  Sanatorium,  Hartford,  Conn.  Foote  &  Townsend, 
Architects,  \ie\v  ot  Front  and  Side  Elevations  and  FLot)R  I'l.ans.  This  is  a  Remodeled 
Farmhouse,  with  ax  Open  Ward  Extension  ix  the  Rear.  Cap.acity,  33  Patients.  Estimated 
Cost,  $15,000. 

83 


Section  II 1 


F1I2JT  TLOO!^  PLAH 


No.  41. — Cuenca  Sanatorium,  Bass  Lake,  Minn.     Alfred  H.  Wheeler,  Architect.     Elevation 
AND  Floor  Plans.     Capacity,  28  Patients.     Cost,  $g,ooo. 


of  a  pri\-ate  room  8  feet  by  8  feet  and  a  nurses'  bedroom  14  feet  long  by  8  feet  wide,  placed 
next  to  the  main  building.  The  capacity  of  the  building  is  thirty-three  patients  at  an 
estimated  cost  of  $15,000. 


The  Cuenca  Sanatorium,  Bass  Lake,  Minn.  (Illustration  41).  This  is  a  frame 
building  on  a  stone  foundation,  with  two  stories  and  a  cellar,  and  two  wings  or  porches 
extending  out  from  the  first  floor.  The  building  is  34  feet  wide  by  60  feet  deep  and  the 
wings  are  each  65  feet  long  by  13  feet  deep. 

On  the  first  floor  is  a  dining  and  living  room  35  feet  wide  b}'  24  feet  deep,  a  kitchen 
20  feet  wide  by  24  feet  deep,  a  small  pantr_v,  hall,  sleeping  room  for  the  cook,  and  store- 
room. On  the  second  floor  are  four  ])ri\-ate  rooms  10  feet  wide  by  14  feet  long,  a  small  corri- 
dor four  feet  wide,  closets,  toilets,  baths,  and  two  wards,  one  10  feet  wide  by  20  feet  long, 
with  three  beds  for  women,  and  the  other  16  feet  wide  by  2^  feet  long,  with  five  beds  for 
mt^n.  The  basement  contains  the  laundry,  and  a  boiler  room,  where  a  gasolene  pumping 
engine  is  installed  to  supply  two  large  water  tanks. 

The  wings  or  sleeping  porches  are  eight  feet  in  the  clear  to  the  ceiHngand  separated 
from  the  central  portion  of  the  building  by  a  room  containing  the  toilets,  baths  and 
lockers  for  the  patients.  Their  fronts  are  open,  but  protected  in  stormy  weather  by 
canvas  curtains,  and  cross-ventilation  is  obtained  through  windows  in  the  rear  walls.  The 
dressing  rooms  in  this  building  are  inadequate  for  ten  patients  and  would  be  better  if 
located  behind  the  porches  and  so  arranged  that  the  patient  would  not  have  to  walk  so 
far  to  reach  them.  The  porches  should  be  wider  and  fH\'ided  by  one  or  more  partitions 
in  order  to  house  the  patients  in  smaller  groups. 

84 


Administration  Buildings  and  Patients'  Quarters  Combined 


No.   42. — Association    Sanatorium,    Colorado    Springs,    Colo.     X.    Van   dex   Arend,   Architect. 
Elevatiox  and  Floor  Plans.     Capacity,  24  Patients.     Estimated  Cost,  S25,cx)o. 


The  building  has  a  capacity  for  twenty-eight  patients,  and  cost,  including  water 
supply,  plumbing  and  sewage  disposal,  $9,000.  It  is  one  of  the  first  of  a  new  tj-pe  of  a 
complete  plant  under  one  roof  for  small  institutions  housing  tuberculous  patients,  and  the 
following  buildings  illustrated  in  this  section  are  of  the  same  t)^e.  but  with  some  improve- 
ments. 


Colorado  Springs  Association  Sanatorium,  Colorado  Springs,  Colo.  (Illus- 
tration 42).  These  plans  were  designed  for  a  small  temporary  reception  hospital  to 
house  all  classes  of  patients  under  one  roof.  The  building  is  to  be  frame  construction 
on  a  stone  foundation,  covered  externally  with  shingles,  and  should  make  an  artistic 
and  attractive  structure.  The  building  consists  of  a  central  section  25  feet  wide  by  80 
feet  deep,  having  a  basement  and  two  stories,  with  wings  or  porches  extending  from 
the  sides  86  feet  long  by  24  feet  wide. 

The  basement  contains  rooms  for  the  heating  plant,  storage  of  coal  and  supplies. 
The  first  floor  consists  of  a  sitting  room  25  feet  wide  by  30  feet  deep,  a  dining  room  25  feet 
wide  by  16  feet  deep,  a  kitchen  16  feet  wide  by  22  feet  deep,  a  pantry  8  feet  wide  by  12 
feet  deep,  store-rooms,  and  an  office  11  feet  wide  by  12  feet  deep.  The  second  floor  is 
one  apartment  of  four  rooms,  all  14  feet  wide  by  14  feet  deep,  and  toilets,  baths  and 
closets  for  the  use  of  the  nursing  staff. 

The  plans  of  this  building  have  the  same  general  arrangement  as  the  Cuenca 
Sanatorium,  with  the  exception  that  all  the  patients  are  to  have  separate  dressing  rooms  at 
the  back  of  the  porches;   this  will  make  the  wings  more  commodious  and  is  an  improve- 

85 


Section  III 


No.  43. — District  Tuberculosis  Hospital,  Lima,  Ohio.  Mi  J,ai  ghlin  and  Hvlskin,  Architects. 
View  of  Troxt  and  Rear  Elevations  and  Floor  Plans.  Present  Capacity,  28  Patients.  Wings 
TO  be  Extended  as  Shown  in  Floor  Plans  with  a  Capacity  for  100  Patients.  (For  plan  of 
basement  see  illustration  Xo.  20.)     Estim.^ted  Cost,  $100,000. 

86 


Administration  Buildings  and  Patients'  Quarters  Combined 

ment.  The  bathrooms  and  toilets  are  situated  next  to  the  main  building,  but  would 
be  made  more  convenient  if  placed  in  the  rear  of  the  wings.  The  capacity  will  be  for 
twenty-four  patients  at  an  estimated  cost  of  $25,000. 

District  Tuberculosis  Hospital,  Lima,  Ohio  (Illustration  43).  This  building 
is  situated  on  a  site  of  fifty-five  acres  in  a  well  wooded  grove  two  and  one-half  miles  from 
Lima,  Ohio,  on  the  Western  and  Interurban  Electric  Road.  It  is  constructed  of  brick,  on 
stone  foundations,  with  brick  porches  facing  the  south  at  the  rear,  and  is  divided  into 
three  sections:  the  centre  for  administration  purposes,  and  two  wings  for  the  patients' 
quarters. 

The  front  of  the  administrative  section  faces  the  north,  and  its  basement  contains 
the  servants'  dining  room  14  feet  wide  by  24  feet  long,  the  kitchen  22  feet  wide  by  24 
feet  long,  bakery  14  feet  wide  by  20  feet  long,  pantry,  vegetable  and  grocery  store  rooms, 
laundry,  heating  and  power  plant,  cold  storage  rooms,  toilets  and  trunk  room  and  a 
mortuary.    (See  Illustration  No.  20.) 

The  first  floor  contains  a  general  dining  room  for  patients,  27  feet  wide  by  29  feet 
long,  a  pantry,  and  dish  sterilizing  room  24  feet  long  by  8  feet  wide,  two  dressing  rooms 
20  feet  wide  by  21  feet  long,  with  lockers,  bath  and  toilets,  staff  dining  room  18  feet  long 
by  14  feet  wide,  store-room  12  feet  wide  by  14  feet  long,  reception  room  14  feet  wide  by 
19  feet  long,  general  office  10  feet  wide  by  14  feet  long,  private  office  11  feet  wide  by  14 
feet  long,  x-ray  room  5  feet  wide  by  14  feet  long,  drug  room  12  feet  long  by  7  feet  wide, 
library  12  feet  long  by  6  feet  wide  and  matron's  room  11  feet  wide  by  14  feet  long. 

The  second  floor  contains  sixteen  rooms  all  about  10  feet  wide  by  13  feet  deep,  and 
baths  and  toilet  for  the  staff,  nurses  and  servants;  also  two  large  dressing  rooms  with 
lockers  and  toilets  arranged  in  the  same  manner  as  on  the  floor  below,  for  the  patients 
in  the  pavilions. 

The  two  sections  of  the  building  used  as  patients"  quarters  are  divided  into  single 
rooms  8  feet  wide  by  12  feet  deep,  which  face  the  south  and  open  in  front  on  to  a  porch 
fifteen  feet  wide  and  in  the  rear  on  a  corridor  leading  to  the  dressing,  toilet  and  dining 
rooms.  One  of  the  institution's  most  interesting  details  is  the  arrangement  of  the  patients' 
lockers  or  closets  3  feet  wide  by  2  feet  deep  between  the  windows  in  the  corridor  at  the  rear 
of  the  rooms. 

The  building  was  planned  to  have  a  capacity  of  one  hundred  patients  housed  in 
separate  rooms  in  the  pavilions  extending  from  the  administration  section  and  ending  at 
the  far  end  in  a  sun  parlor  or  sitting  room  20  feet  wide  by  35  feet  long,  but  as  the  funds 
to  complete  the  original  plans  as  illustrated  were  not  appropriated  these  pavilions  are 
unfinished.  At  present  there  are  only  rooms  for  twenty-eight  beds,  the  ends  of  the  wings 
with  a  number  of  rooms  and  the  sitting  rooms  not  ha\'ing  been  built,  but  the}'  will  be 
completed  as  more  room  is  needed. 

The  present  building  cost  $So,ooo.  This  includes  a  water  tower  one  hundred  and 
twenty-six  feet  high  filled  from  an  artificial  lake  constructed  for  the  hospital,  the  power 
plant  in  the  basement,  plumbing  and  administration  facilities  for  one  hundred  patients. 

Plan  for  a  Small  Village  or  Town  Sanatorium  (lUustration  44).  This  is  a 
design  for  a  small  tuberculosis  hospital  or  sanatorium  to  house  an  entire  plant  under  one 
roof.  It  has  a  capacity  for  fourteen  patients,  but  the  dormitory  wings  can  be  built  two 
stories  high  and  the  number  increased  to  twenty-four.  It  is  an  interesting  and  com- 
pact design  for  a  small  village  or  town  institution  housing  incipient  cases,  and  the  floor 

87 


Section  111 


No.  44.— A  Design  for  a  Small  Village  or  Town  Hospital  or  Sanatorium.     Front  Elevation  and 
Floor  Plan.     Capacity,  14  Patients.     Estimated  Cost,  $15,000. 


plans  can  be  adapted  for  advanced  cases  without  greatly  adding  to  the  expense  of  construc- 
tion, by  increasing  the  length  of  the  dormitory  wings  eight  feet,  and  placing  partitions 
between  the  beds.  The  first  floor  should  be  built  of  brick  or  reinforced  concrete  on  a  stone 
foundation  with  a  basement  under  the  entire  structure;  the  second  floor  walls  of  stucco 
on  metal  lath  finished  in  colors  or  with  dashed  pebbles,  and  the  roof  of  stained  shingles. 
The  building  will  be  one  hundred  feet  along  the  front  by  twenty-four  feet  deep  through 
the  wings.  The  dormitories  14  feet  wide  by  25  feet  long,  and  the  porches  7  feet  wide  by 
32  feet  long.  The  front  walls  dividing  the  dormitories  from  the  porches  are  constructed 
of  pillars  with  windows  between,  which  can  be  pushed  u})  out  of  the  way,  leaving  the 
space  entirely  clear.  There  are  also  windows  in  the  rear  and  side  walls  giving  good  cross- 
ventilation.  At  the  end  of  the  dormitories  next  to  the  central  section  of  the  building 
are  bathrooms,  toilet  and  lockers  for  the  patients.  The  lockers  are  3  feet  wide  by  3  feet 
deep  in  order  to  give  a  small  private  space  to  each  person. 

The  central  section  of  the  first  floor  is  divided  into  a  reading  room  1 2  feet  long  by 
12  feet  wide,  a  dining  room  17  feet  long  by  12  feet  wide,  a  kitchen  13  feet  long  by  14  feet 
wide  and  a  pantry.  The  second  floor  contains  two  small  wards  for  two  patients  each 
and  a  nurses'  apartment  divided  into  a  sitting  room,  bedroom  and  bath. 

The  entire  building  is  to  be  heated  by  a  steam  plant  in  the  cellar  and  should  be 
situated  so  it  can  be  connected  with  the  city  sewers  and  lighting  service.  The  estimated 
cost  is  $15,000. 


88 


SECTION  IV 


Hospitals  for  Advanced  Cases,  Infirmaries  and 

Reception   Hospitals 


Section  IV 


SECTION  IV 


Hospitals  for  Advanced  Cases,  Infirmaries  and  Reception 

Hospitals 


The  three  types  of  buildings  grouped  together  in  this  section  for  description,  are 
all  intended  for  patients  who  need  comfort,  good  nursing,  and  the  housing  supplied  by  a 
general  hospital.  They  are  used  for  the  same  general  purposes,  that  is,  for  the  care  of 
cases  too  sick  to  look  after  themselves,  and  at  many  institutions  one  building  serves  the 
purpose  for  which  all  are  constructed  and  therefore  it  is  hardly  possible  to  separate  them 
for  purposes  of  description. 

Hospitals  for  Advanced  Cases 

These  buildings  are  intended,  as  their  name  indicates,  to  house  and  care 
for  patients  who  are  unable,  because  of  the  advanced  condition  of  their  disease, 
to  live  in  lean-tos  or  open  cottages.  They  are  usually  built  on  the  lines  of  a  general  hos- 
pital, either  the  entire  plant  under  one  roof  (as  described  in  Section  III)  or  on  the  pavilion 
plan.  Also  sometimes  as  a  separate  pavilion  in  connection  with  a  general  hospital  or 
sanatorium  in  the  open  country. 

An  advanced  case  hospital  does  not  mean  a  home  for  incurables,  for  there  can  be 
no  hard  and  fast  line  of  demarcation  drawn  between  curable  and  incurable  cases.  It  has 
been  found  that  many  patients  sent  to  institutions  where  they  may  be  isolated  until  their 
death,  improve  under  good  hygienic  surroundings  and  recover  for  all  practical  purposes. 
It  is  the  opinion  of  many  authorities  that  the  advanced  case  does  better  on  a  porch  in  the 
open  air  than  in  an  enclosed  room  and  can  stand  with  benefit  a  comparatively  large  amount 
of  cold  and  exposure.  It  is  therefore  necessary  that  buildings  for  this  purpose,  besides 
being  heated,  and  supplied  with  the  comforts  and  conveniences  of  a  general  hospital,  must 
also  have  large  verandas  connected  with  the  wards  and  rooms  by  windows,  cut  down  to 
the  floor,  and  doors  through  which  beds  can  be  rolled,  in  order  to  provide  the  same  facilities 
for  the  open  air  treatment  necessary  for  incipient  cases.  Such  porches  should  be  used  in 
pleasant  weather  by  patients,  even  when  far  advanced  in  the  disease,  as  there  is  hope  for 
all,  when  they  are  not  in  a  dying  condition. 

Where  very  ill  patients  are  to  be  cared  for,  it  will  give  them  comfort  and  save  much 
labor  if  the  rooms  and  porches  are  connected  by  some  arrangement  such  as  the  Indiana 
Convertible  Sleeper,  installed  at  the  Indiana  State  Hospital  (Illustration  46),  which 
consists  of  a  space  three  feet  six  inches  wide  across  the  entire  front  between  the  porch  and 
room,  enclosed  on  the  outside  by  a  glass  and  sash  window  that  can  be  raised  or  lowered, 
and  on  the  inside  by  glass  doors  that  can  be  opened  or  shut.  In  this  clear  space  between 
the  doors  and  windows  is  placed  the  bed,  three  feet  wide,  which  is  cut  off  from  the  room 
when  the  doors  are  closed,  and  cut  off  from  the  porch  when  the  window  is  lowered.  If 
doors  and  windows  are  both  open,  the  front  of  the  room  is  entirely  clear  to  the  porch. 
It  is  claimed  for  this  arrangement  that  patients  can  be  exposed  to  the  air  on  the  porch, 

91 


Section  IV 


OT^enco  Ou7 


No.  46. — Indiana  State  Hospital,  Rockville,  Ind.  Brubaker  &  Stern,  Architects.  "Con-\'ertible 
Sleeper,"  Showing  .Arrangement  fur  Connecting  Rooms  with  Open  Porches,  in  Order  to 
Enpose  the  Patients  to  the  Outer  .\ir  or  Place  Them  in  Heated  Rooms  without  Moving  the 
Beds.     (See  illustrations  7,  26  and  51  for  further  description  of  this  institution.) 


cr  removed  from  it  and  placed  in  the  heated  rooms,  without  disturbing  them  or  moving 
the  bed. 

An  essential  point  to  be  considered  in  planning  buildings  for  advanced  cases  is, 
that  tuberculous  patients  in  the  last  stages  of  the  disease  are  very  annoying  to  each  other, 
and  should  therefore  be  housed  in  separate  rooms  instead  of  wards.  They  are  easily 
affected  by  disturbances,  and  any  excitement,  such  as  grief,  anger  or  worry,  is  usually  fol- 
lowed by  a  fit  of  coughing  and  depression.  Coughing  is  not  only  bad  for  the  indi\idual, 
but  when  patients  are  housed  in  wards,  it  may  disturb  ten  or  fifteen  others,  and  is  also  a 
strong  suggestion  which  often  causes  an  epidemic  of  coughing  among  them.  The  mistake 
and  cruelty  of  placing  in  one  room  a  number  of  persons  suffering  from  a  serious  chronic 
disease  is  only  just  beginning  to  be  appreciated;  and  there  is  no  doubt  that  many  patients 
who  fail  to  make  satisfactory  progress  against  disease  when  housed  in  wards,  rapidly 
improve  when  removed  to  the  cjuiet  and  privacy  of  a  separate  room.  The  single  room 
pavilions  are  slightly  more  expensive  to  construct  than  the  ward  buildings,  but  they  have 
advantages  and  it  is  easier  to  manage  patients  housed  in  them.  The  psychological  tendency 
of  a  private  room  is  to  make  patients  more  contented,  and  also  to  increase  their  self-respect. 

Advanced  case  hospitals  are  built  not  only  in  t)rder  to  care  for  the  patient,  but  also 
to  prevent  the  spread  of  pulmonary  tuberculosis,  which  is  due  in  a  great  measure  to  the 
cases  of  consumption  which  remain  and  die  in  their  homes  infecting  other  members  of  their 
families.  If  all  ad\-anced  cases  could  be  cared  for  in  hospitals,  the  disease  would  more 
rapidly  disappear.  Public  opinion  at  present  will  not  allow  the  passage  of  laws  compelling 
persons  in  the  advanced  stages  of  this  disease  to  enter  institutions  for  their  segregation; 
therefore,  hospitals  should  be  made  comfortable  and  home-like  in  order  to  attract  the 
patients  and  hold  them. 

There  are  now  in  use  for  advanced  cases  at  open  air  sanatoria  pavilions  constructed 
on  the  lean-to  plan  with  the  porches  divided  into  single  rooms  and  finished  with  plaster  on 
the  interior.     They  are  closed  in  front  with  glass  and  sash  windows  and  make  very  satis- 


Hospitals  for  Advanced  Cases,  Infirmaries  and  Reception  Hospitals 


factory  quarters  when  heated.  It  is  a  simple  method  of  housing,  has  the  advantage  of  pro- 
viding plenty  of  porch  space  and  is  economical.  A  lean-to  for  sixteen  patients  finished  for 
advanced  cases,  can  be  built  for  from  $5,000  to  $10,000,  and  when  near  an  administration 
building,  administered  as  easily  as  a  more  costly  structure. 


Infirmaries 

In  large  cities  where  a  hospital  for  the  care  of  ad\'anced  cases  has  a  working  connec- 
tion with  an  open  air  sanatorium  in  the  country  for  the  cure  of  incipient  consumption,  it 
has  been  found  that  there  is  more  or  less  interchange  of  cases  between  the  two  institutions. 
Patients  taken  into  the  hospital  for  advanced  cases,  to  be  cared  for  until  they  die,  often  im- 
prove under  nursing,  good  food  and  hygienic  surroundings,  and  are  then  sent  to  the  country, 
while  others  who  go  to  the  sanatorium  for  the  cure  seemingly  only  incipient  cases,  gradually 
fail  in  strength  or  develop  acute  symptoms  and  have  to  be  sent  to  the  city  hospital  and 
remain  there  until  they  die. 

This  peculiarity  of  the  disease  has  created  a  need  for  buildings  on  sanatorium  grounds, 
where  patients  who  have  come  to  be  cured,  but  de\'elop  symptoms  of  advanced  disease,  can 
be  housed  and  cared  for  until  they  improve  or  are  discharged.  There  is  also  a  need  in  all 
large  sanatoria  for  a  building  where  patients  taking  the  open  air  treatment  can  be  placed  if 
they  develop  some  other  acute  disease  which  requires  nursing.  Buildings  used  for  these 
purposes  are  called  infirmaries,  and  combine  the  structural  details  of  both  the  general  hos- 
pital and  the  large  open  air  buildings  of  the  sanatorium.  They  are  often  constructed  as  a 
complete  unit  and  administered  separately  from  the  other  sanatorium  buildings.  Many 
of  them  have  a  dining  room,  kitchen  and 
quarters  for  nurses  and  servants,  who  do 
not  have  any  relationship  except  an  official 
one,  with  other  parts  of  the  institution. 
In  some  instances  the  infirmary  building 
houses  the  medical  department  and  may 
be  designated  the  mecUcal  building,  as 
illustrated  in  this  section,  by  the  Adiron- 
dack Cottage  and  Edward  Sanatorium 
infirmaries. 

These  buildings  should  be  heated 
and  constructed  of  good  material,  fire-proof 
if  possible,  and  with  all  the  sanitary  pre- 
cautions taken  to  make  a  general  hospital 
comfortable  and  convenient,  and  the  mate- 
rial used  in  them  from  becoming  infected. 

Reception  Hospitals 

A  reception  hospital  is  intended  to 
pro\ide  a  place  for  the  temporary  care  of 
cases  arriving  at  institutions  for  the  treat- 
ment of  pulmonary  tuberculosis  and  where 

4.U  t.-     i  1  ]        u  No.  47. — Isolation  Hospital,   Paterson,   N.   J. 

these  new  patients  may  be  under  observa-        '■^°-  fl,^,,,,,    K.  Wnrn     Architect.    \ieu    .-If 

tion  in  order  that  the  physicians  can  classify  the  Corner  of  One  of  the  Porches  Showing 

4.U      4.  f  iU   •    J-         '       ji   ^      ^1     -J-  Method  OF  Heating  for  .Advanced  Cases  BY 

the  stage  of  their  disease  and  learn  the  idio-  StSi  Pipes.    (See  illustration  52  for  further 

syncrasies  of   each    case   under   fresh  air  description  of  this  institution.) 


93 


Section  IV 


treatment  before  placing  them  in  open  shacks  and  cottages.  Recei)tion  hospitals  are 
also  used  for  the  same  purposes  as  infirmaries  and  should  be  constructed  in  the  same 
manner  and  with  as  good  material  as  is  used  for  achanced  case  l)uildings. 


exa:\iples  of  hospitals  for  advanced  cases 

Riverside  Hospital,  New  York  City,  The  Concrete  Pavilion  (Illustration  48). 
This  building  is  constructed  of  reinforced  concrete,  in  feet  long  by  18  feet  wide  through 
the  wards,  and  was  designed  on  the  lines  of  a  lean-to  four  stories  high;  a  sitting  room 
between  two  open-air  pa\'ilions  with  dressing,  toilet  and  bath  rooms  in  a  rear  extension. 
It  is  used  for  advanced  cases  and  arranged  so  that  the  front  can  be  thrown  entirely  open, 
converting  the  wards  on  each  story  into  open-air  porches.  This  building  was  designed 
to  be  used  interchangeably  for  the  care  of  cases  of  tuberculosis  and  the  contagious  dis- 
eases (measles,  scarlet  fever,  etc.),  according  to  the  needs  of  the  service. 

The  wings  on  the  first  floor  are  36  feet  long  by  16  feet  wide,  with  an  apartment 
between  them  29  feet  long  by  15  feet  wide  used  as  a  dining  room.  The  wards  on  the 
second  and  third  floors  are  41  feet  long  by  16  feet  deep,  with  a  sitting  room  18  feet  wide 
by  2T  feet  deep  in  the  centre.  The  fourth  story  or  roof  garden  is  divided  into  two  open 
wards  and  one  open-air  sitting  room  of  the  same  dimensions  as  those  below. 

The  Riverside  Hospital  for  advanced  tuberculous  patients  is  on  North  Brother 
Island  at  the  upper  end  of  the  East  River  near  Long  Island  Sound.  The  institution  is 
in  an  isolated  position.  The  air  is  pure  and  so  far  as  climatic  conditions  are  concerned 
is  an  ideal  site  for  a  sheltered  open  air  building.  The  authorities  feel  that  the  advanced 
patients  sent  there  should  be  housed  in  a  manner  that  wfll  give  them  every  chance  of  a 
cure,  and  these  concrete  pavilions  are  being  built  as  an  experiment  with  the  hope  that  some 
of  the  cases  will  respond  to  the  treatment  and  that  all  the  patients  housed  in  these  structures 
will  do  better  than  they  did  in  the  old  block  type  of  hospital. 

This  building  has  a  capacity  of  seventy-eight  patients  and  the  estimated  cost  is 
$40,000.  • 

Jewish  Hospital  for  Consumptives,  Reisterstown,  Md.,  Advanced  Case 
Pavilion  f  Illustrations  49  and  50).  The  building  is  153  feet  long  including  the  side  porches, 
and  57  feet  deep  through  the  wings;  located  on  the  southern  slope  of  a  hill,  with  a 
basement  above  ground  on  the  south  side.  The  material  used  for  the  foundations 
and  walls  of  the  basement  is  native  stone,  for  the  first  story  pressed  brick,  and  the  second 
story  rough  stucco  on  metal  lath.  The  interior  walls  and  ceilings  are  of  hard  plaster  with 
round  corners,  covered  with  non-absorbent  washable  paint,  and  finished  in  plain  wood 
surfaces;  the  floors  are  of  hard  wood  dressed  with  oil. 

The  basement  contains  the  dining  room  51  feet  wide  by  30  feet  deep,  kitchen  23 
feet  wdde  by  28  feet  deep,  serving  room,  pantry,  fuel  storage,  laundry,  sterilizing  and  drying 
rooms.  There  are  sixteen  single  rooms  in  the  building  10  feet  wide  by  12  feet  deep  and 
10  feet  high,  and  two  wards  of  four  beds,  each  patient  being  allotted  twelve  hundred  cubic 
feet  of  air  space.  The  sleeping  porches  in  the  centre  of  the  building  are  83  feet  long  by  1 2 
feet  wide,  protected  at  each  end  by  the  extension  of  the  building,  twelve  feet  to  the  south. 
The  reception  room,  21  feet  wide  by  23  feet  long,  and  the  su])erintendent's  quarters,  which 

94 


Hospitals  for  Advanced  Cases,  Infirmaries  and  Reception  Hospitals 


?^CH/J^T>i  .^OCiU>L^f/' 


—j6  IHsr  s4~Sr.  TVyOry^ — 


■SEtxnn  s  7wu>  .loce  Pj-a// 


jli{HEJ(^iIi£  .VcxSP/TAi. 


No.  48.— Riverside  Hospital,  New  York  City.    Designed  by  Ur.  Hermann  M.  Biggs.    Westervelt 
&  Austin,  Architects.     Concrete  P.wilion  for  .\dv.\nced  Cases.     Front  Ele\ation  and 
Floor  Plans.     Capacity.  78  Patients.     Estimated  Cost,  S40.000. 


95 


Section  IV 


consist  of  office,  sleeping  room,  bath  and  toilet,  are  on  the  first  Hoor  in  the  east  wing. 
The  main  entrance  is  on  the  first  lloor  in  the  centre  of  the  building,  and  leads  by  a  stairway 
to  all  the  floors. 

The  rear  extensions  at  the  ends  of  the  building  are  28  feet  deep  from  the 
wall  of  the  corridor  and  25  feet  wide,  and  contain  the  nurses'  rooms,  toilets  and  baths, 
service  stairways,  lockers,  diet  kitchens,  patients'  toilets  and  baths,  drug  and  supply  rooms. 
The  centres  of  both  the  upper  floors  are  used  for  housing  the  patients.  Their  sitting  rooms, 
porches  and  sleeping  apartments  face  the  south  and  are  protected  from  the  north  winds 
by  a  heated  corridor  extending  the  entire  length  of  the  building. 

Al!  the  rooms  are  heated  by  direct  steam  radiators,  lighted  by  electricity,  provided 
with  electric  bed  warmers,  have  electric  connections  with  the  nurses'  apartments  and  are 
screened  against  insects.  The  doors  open  on  to  a  porch  in  front  and  into  a  corridor  at  the 
rear  six  feet  wide,  and  over  them  are  movable  transoms  giving  cross-ventilation  above  the 
beds.  The  doorways  are  wide  and  have  no  sills,  so  that  the  beds  can  be  rolled  through 
either  end  and  moved  from  one  floor  to  another  on  the  elevator. 

The  building  was  erected  for  advanced  cases  with  the  idea  of  obtaining  unol)structed 
cross-ventilation  from  every  direction  without  mechanical  means,  and  of  giving  most  of 
the  patients  an  individual  room  with  porch  space  equal  to  its  floor  area.  The  building 
has  a  capacity  of  twenty-four  beds  and  cost  $30,000. 


^    9wn\    m   s    "^i  ji  "1  iS  |!?'"f 

I-  . 


.■jfssr  "St** 


^Ht'?'-- 


No.  49."  Jewish  Hospital  for  Consumptives,  Reisterstown,  Md.     I'.w  ilion  ihjr  Advanied  Cases. 
\'ii;\v   OF   Front  and   Rear   Et.kvations.     Capacitv,   24   Patients.     Cost,  $30,000. 

96 


Hospitals  for  Advanced  Cases,  Infirmaries  and  Reception  Hospitals 


.^CALE^INCM   C^UfcL^I  Pi^JT. 


FIRJST    FLOOR     PUAn 


I 
I 


E- A.^E/AE.-^T   PLAT 


No.  50.— Jewish  Hospital  for  Consumptives,  Reisterstown,  Md.     Pavilion  for  Advanced  Cases. 

Floor  Plans.     Capacity,  24  Patients.     Cost,  830,000. 


Indiana  State  Hospital,  Rockville,  Ind.,  W.\rd  Buildixg  (Illustration  51). 
This  is  one  of  two  similar  buildings  connected  with  the  administration  building  illustrated 
in  Section  II.  It  is  295  feet  long,  50  feet  deep  through  the  centre  and  25  feet  deep  through 
the  wings,  two  stories  without  a  basement,  and  of  frame  construction  on  a  concrete  founda- 
tion. On  each  side  of  the  central  section  the  w'ngs  are  divided  into  a  row  of  single  rooms 
10  feet  wide  by  10  feet  deep,  with  a  sleeping  porch  10  feet  wide  and  100  feet  long  in  the 
front,  and  a  corridor  five  feet  wide  in  the  rear.  In  the  centre  is  a  sun  parlor  30  feet  wide  by 
7,7,  feet  deep,  a  nurses'  room  14  feet  wide  by  20  feet  deep,  a  diet  kitchen  13  feet  wide  by  13 
feet  deep  and  a  serving  room.  At  the  outer  ends  are  the  patients'  toilets,  baths  and 
lavatories. 

The  corridor  in  the  rear  of  the  rooms  on  both  stories  is  connected  by  an  enclosed 
passageway  with  a  hall  in  the  administration  building,  in  order  that  the  patients  may  be 
sheltered  in  bad  weather  while  going  to  and  from  their  meals.  Under  these  passage- 
ways are  tunnels  connecting  the  pavilions,  administration  building  and  power  house,  and 
carrying  the  service  pipes,  lighting  wires  and  heating  mains. 

The  rooms  on  the  first  floor  are  protected  on  the  front  by  double  glass  doors  opening 
out  on  to  the  sleeping  porches,  through  which  the  beds  can  be  run  when  desired.     Those 

7  97 


Section  l\ 


^ 


■^jff^J^j^^^^^f^^  ^     -J^^^^^^^^^^j^^j^^ 


No.  51. — Indiana  State  Hospital,  Rockville,  Ind.  Ward  Building.  Brubaker  &  Sterx, 
Architects.  \'ie\v  of  Front  Elevation  and  Floor  Plan;  Both  Floors  Alike.  Capacity,  40 
Patients.  Estimated  Cost,  $30,000.  (See  illustrations  7,  26  and  46  for  further  description  of  this 
institution.) 

on  the  second  floor  are  ecjuipped  with  an  arrangement  called  the  "Indiana  Convertible 
Sleeper,"  described  on  pages  91  and  92. 

The  building  has  a  capacity  for  forty  patients,  all  housed  in  single  rooms,  at  an  esti- 
mated cost  of  $30,000. 


Isolation  Hospital,  Paterson,  N.  J.,  Tuberculosis  Pavilion  (Illustration  52). 
This  is  a  two  story  building  constructed  of  reinforced  concrete,  with  concrete  floors,  and  is 
fire-proof  throughout  with  the  exception  of  the  window  frames  and  the  framework  of  the 
porches.  It  is  a  pavilion  to  house  advanced  tuberculous  patients  in  connection  with  the 
Paterson  Isolation  Hospital,  from  which  it  is  administered. 

The  building,  not  including  the  porch,  is  56  feet  deep  by  27  feet  wide.  The  floor 
plans  of  both  stories  are  alike,  divided  into  a  ward  24  feet  wide  by  25  feet  deep,  two  private 
rooms  10  feet  wide  and  12  feet  long,  a  linen  room  6  feet  wide  by  10  feet  long,  a  diet  kitchen 
7  feet  wide  by  10  feet  long,  and  a  nurses'  sitting  room  8  feet  wide  by  10  feet  long,  containing 
a  private  toilet  and  stationary  wash-stand,  and  a  lavatory  10  feet  by  10  feet,  containing 
bath,  wash-basins  and  toilet  for  the  patients. 

The  porches  extend  on  both  stories  along  the  entire  front,  12  feet  wide  by  t,S  feet 
long,  and  on  the  south  side  of  the  building  11  feet  wide  by  42  feet  long,  floored  with  con- 

98 


Hospitals  for  Advanced  Cases,  Inlirmarics  and  Reception  Hospitals 


Crete,  enclosed  with  swinging  glass  and  sash  windows  and  heated  by  steam  pipes  which 
extend  along  their  outer  edges.     (See  illustration  No.  41.) 

The  pavilion  has  a  capacity  of  twenty-four  beds  and  cost  812,096,  but  this  does  not 
include  its  proportion  of  the  expense  of  the  pow-er  house  or  the  enclosed  corridor  construc- 
tion, which  connects  it  with  the  administration  building. 

United  States  Army  General  Hospital,  Fort  Bayard,  N.  M.,  Officers' 
Dormitory  (Illustration  53).  This  is  a  single  story  building  with  a  stone  foundation  and 
walls  of  frame  with  brick  veneer  externally.     The  roof  is  shingled  and  the  interior  walls 


FIRST  AND  SECOND    STORY 
FLOOR     PLANS 


No.  52. — Isolation  Hospital,  Paterson,  N.  J.  Charles  E.  White,  .\rchitect.  Pavilion  for 
Advanced  Cases.  \iew  of  Front  and  Slde  Elevation.  Floor  Plan;  Both  Floors  .\re 
Alike.  Cap.acity,  24  Patients.  Cost,  $12,096.  (See  illustration  47  for  further  description  of  this 
institution.) 

99 


Section  IV 

plastered.  The  building  is  147  feet  long  by  34  feet  wide,  heated  by  a  hot  water  system 
and  lighted  by  electricity.  It  is  divided  down  the  centre  by  a  corridor  six  feet  six  inches 
wide,  and  has  eighteen  rooms  for  patients,  twelve  on  the  south  side  and  six  on  the  north 
side,  all  of  the  same  dimensions,  11  feet  wide  by  13  feet  deep.  These  rooms  open  upon 
covered  sleeping  porches  about  ten  feet  wide,  with  doorways  made  wide  enough  so  that 
the  beds  can  be  rolled  through  them.  There  is  also  an  ofKice  11  feet  wide  by  13  feet  long, 
an  attendants'  room,  baths  and  toilets.  The  capacity  is  eighteen  patients  and  the  building 
cost  $18,534. 

United  States  Army  General  Hospital,  Fort  Bayard,  N.  M.,  Enlisted  Men's 
Ward  No.  2  (Illustrations  54  and  55 ).  Ward  Two  is  a  single  story  structure,  constructed  of 
concrete  with  "pebble-dash"  finish  and  built  around  a  central  court  or  "patio"  59  feet  wide 
by  79  feet  long.  The  building  including  the  court  covers  ground  space  100  feet  wide  by 
130  feet  long.  Platforms  or  porches  ten  feet  wide  extend  around  the  interior  of  the  building 
on  the  sides  of  the  court  where  the  beds  of  the  patients  are  placed  and  protected  from  rain 
and  sun  by  canvas  curtains  on  rollers.     At  the  corners  of  the  building  are  rooms  2^,  feet 


No.  53.— United  States  Army  General  Hospital,  Fort  Bayard,  N.  M.     Officers'  Quarters.     View 
OF  Front  anu  Side  Kli:\ation  and   Ii.uor  Pi.w.     I'apahty,   18  Patients.     Cost.  $18,534. 


100 


Hospitals  for  Advanced  Cases,  Infirmaries  and  R;eCeptiQrt']jlt>Jipitals 


tf 


t     H    ^    %    > 


•^i^fcw 


It         tI 


No.  54. —United  States  Army  General  Hospital,  Fort  Bayard,  N.  M.     Designed  by  :\Iajor  George 

E.  BusHXELL.     Hnusted  Men'sWard  Xo.  2.     \iE\v  OF  Front  and  Side  Elevation 

AND  Floor    Plan.     Capacity,  32  Patients.     Estimated  Cost,  825,000. 


lOI 


Section  I\ 


No.  55. — United  States  Army  General  Hospital,  Fort  Bayard,  N.  M.     \'iew  of  Ixner  Court 

SiiowiNt;  Sleeping  Porches. 


wide  by  23  feet  deep,  used  for  offices,  lavatories,  storage  and  attendants.  These  rooms  are 
connected  by  long  narrow  apartments  14  feet  wide  by  68  feet  long,  on  two  sides  of  the 
building,  and  14  feet  wide  by  50  feet  long  on  the  others,  intended  as  dressing  rooms  rather 
than  sleeping  rooms,  but  used  for  the  latter  purpose  in  stormy  weather.  Numerous 
French  windows  open  from  the  dressing  rooms  on  to  the  porches  facing  the  court  and  also 
upon  porches  constructed  on  the  outside  of  the  building.  This  arrangement  permits  the 
beds  and  reclining  chairs  to  be  moved  freely  on  to  a  platform  ha\-ing  any  exposure  desired 
and  gives  the  patients  an  opportunity  to  seek  or  avoid  the  sun  at  pleasure.  It  is  reported 
to  be  very  satisfactory  and  that  two  other  buildings  of  the  same  design  will  be  constructed. 
This  type  of  building  is  especially  good  for  dry,  tropical  countries,  but  can  be  used  for 
patients'  quarters  in  any  climate  if  the  porches  are  protected  by  permanent  roofs.  It 
has  a  capacity  for  forty  patients  and  the  estimated  cost  is  $15,000. 


Lakeville  Tuberculosis  Hospital,  Middleboro,  Mass.,  The  Advanced 
Case  Pavilion  (Illustration  56).  This  structure  is  one  of  a  group  of  buildings  put 
up  as  a  State  Hospital  for  housing  all  classes  of  cases.  It  is  two  hundred  and 
forty-eight  feet  long,  of  frame  construction,  placed  on  a  stone  foundation,  and  stone 
piers.  It  consists  of  a  central  section  36  feet  wide  by  62  feet  deep  (including  the  rear 
extension),  two  twenty-bed  wards  64  feet  long  l)y  20  feet  wide,  and  two  twelve-bed  open 
air  pavilions  built  in  the  form  of  a  right  angle,  extending  forty  feet  from  the  outer  ends  of 
the  wards.  The  central  section  of  the  building  has  two  stories  and  a  cellar.  On  the  first 
floor  is  a  sun  parlor,  three  small  wards,  a  diet  kitchen,  treatment  room,  toilets  and  baths. 


102 


Hospitals  for  Advanced  Cases,  Infirmaries  and  Reception  Hospitals 


The  second  story  is  36  feet  wide  by  50  feet  deep  and  is  divided  into  nine  rooms.  The 
cellar  is  of  about  the  same  size  and  is  used  for  lockers,  toilet  rooms  and  storage  purposes. 
The  large  wards  are  an  objection  to  using  the  plan  for  this  building,  but  they  could  be 
divided,  and  it  is  easy  to  administer.  It  would  also  be  improved  by  di\-iding  the  locker 
rooms,  bath  rooms,  and  toilets  on  the  main  floor  into  two  sections,  pro\-iding  a  nurses' 
office,  one  or  two  niore  private  rooms,  a  larger  sun  room,  and  larger  wards,  giving  more 
air  space  to  each  patient. 

The  building  has  a  capacity  for  seventy  patients,  and  cost  $17,600. 

Boston  Consumptives  Hospital,  Boston,  Mass.,  Cottage  for  Advanced 
Cases  (Illustration  57).  This  is  a  frame  building  with  a  shingle  roof,  placed  on  a  concrete 
foundation  and  concrete  piers.  The  interior  walls  are  plastered  and  the  floors  are  of 
first  quahty  maple.  The  building  is  144  feet  long  and  25  feet  through  the  w-ards,  including 
the  porches,  with  a  rear  extension  45  feet  deep  and  28  feet  wide.  At  the  front  in  the  centre 
is  an  assemblv  room  22  feet  wide  by  24  feet  deep  and  in  the  rear  extension  an  emergency 


10  SEP  Ward 


1. 


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TiRsT  Tloor  Plan 


No.  56.— Lakeville  Tuberculosis  Hospital,  Middleboro,  Mass.     John  A.  Fox,  Architect.    Pavilion 
FOR  Ad\anced  Cases.     \'ik\v  of  Front  and  Side  Ele\ation  and  Floor  Plan.     Capacity,  70 

Beds.     Cost,  Si 7.000. 


103 


Section  IV 


No. 


57. — Boston   Consumptives    Hospital,   Mattapan,   Mass.      Maginnis,   Walsh   &    Sullivax, 
Architects.     Cottage  Ward  eor  .Vdvaxced  Cases.    \"ie\v  of  Front  Elevation  and 
Floor  Plan.     Capacity,  24  Patients.     Cost,  $14,000. 


ward  of  two  beds  and  a  nurses'  room,  both  10  feet  wide  by  11  feet  deep,  two  dressing  rooms 
14  feet  wide  by  21  feet  deep,  each  containing  twelve  lockers  3  feet  wide  and  2^  2  feet  deep, 
and  two  toilet  rooms  27  feet  wide  by  13  feet  deep,  furnished  with  six  lavatories,  four  toilets, 
two  baths  and  two  showers.  The  wards  face  the  south,  are  14  feet  wide  by  16  feet  long, 
and  each  contains  a  single  row  of  twelve  beds,  with  a  veranda  in  their  front  10  feet  wide 
by  60  feet  long,  separated  from  the  wards  by  a  glass  partition  made  up  of  triple  hung  windows 

104 


Hospitals  for  Advanced  Cases,  Infirmaries  and  Reception  Hospitals 

extending  from  the  roof  to  the  floor.     Along  the  north  side  of  the  wards  is  a  row  of  windows 
which  give  cross-ventilation. 

It  has  been  suggested  that  doors  be  substituted  for  the  triple  hung  windows  on  the 
front,  as  they  are  rather  heavy  and  hard  to  move.'  This  ward  is  for  slightly  advanced 
cases  and  is  very  satisfactory  for  the  purpose.  It  is  heated  by  steam,  lighted  by  electricity, 
has  a  capacity  for  twenty-six  patients,  and  cost,  including  equipment,  Si 5,000. 

EXAMPLES  OF  INFIRMARIES  AND  RECEPTION  HOSPITALS 

Maine  State  Sanatorium,  Hebron,  Me.,  The  Infirmary  (Illustration  58). 
This  is  a  frame  structure,  on  a  stone  foundation.     Under  the  left  wing  the  ground  falls  off  to 


iPBl 


No.  58. — Maine  State  Sanatorium,  Hebron,  Me.     T.  C.  Stevens  and  J.  H.  Stevens.  Architects. 

Infirmary.     View  of  Front  Elevation  and  Floor  Plan.     Capacity,  30  Patients.     Estimated 

Cost,  S30.000.     (See  illustrations  11  and  2^  for  further  description  of  this  institution.; 


10; 


Section  IV 


such  an  extent  that  an  open  ward  was  constructed  in  the  basement,  providing  an  arrange- 
ment similar  to  that  on  the  floor  above.  The  building  consists  of  a  centre  section,  two 
stories  high,  two  wings  and  a  rear  extension.  The  front  of  the  building  is  in  the  form  of 
an  acute  angle  and  has  a  porch  running  its  entire  length,  eleven  feet  wide.  The  wings  are 
32  feet  wide  by  61  feet  long,  divided  into  nine  single  rooms  each  7  feet  wide  by  11  feet 
deep,  with  a  closet  3  feet  wide  by  2  feet  deep,  and  a  passageway  or  corridor  four  feet 
wide  in  their  rear.  It  should  be  noted  that  the  rooms  are  ventilated  by  transoms  opening 
above  the  roof  of  the  porch  through  which  sunlight  is  obtained  and  that  the  arrangement  of 
closets  in  connection  with  the  sleeping  rooms  is  unusual.  Behind  the  corridor  in  each  wing 
is  an  extension  27  feet  long  by  7  feet  deep,  containing  lavatories,  toilet  and  baths. 

The  central  section  of  the  building,  including  the  rear  extension,  is  30  feet  wide 


No.  59.  Municipal  Sanatorium,  Otisville,  N.  Y.  Dksigxkd  by  Dr.  Hkrmanx  M.  Biggs.  J.  D.  Burt, 
Akchitf.ct.  Women's  Inkirmarv.  \'ii;\vs  of  Front  and  Rear  Elevations.  Cap.\city,  24 
Patients.  Estimated  Cost,  $5,000.  (Seeillvisirations  14,  28,  85,  04  and  loi  for  further  (lescriptions 
of  this  inslilution.) 

106 


Hospitals  for  Advanced  Cases,  Infirmaries  and  Reception  Hospitals 


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No.  60. — Municipal  Sanatorium,  Otisville,  N.  Y.     Designed  by  Dr.  Hermann  M.  Biggs.    J.  D.  Bi"rt, 
-\rchitect.     Women's  Infirmary.     Floor  Pl.\ns.     Capacity,  24  Patients.     Estimated 

Cost.  S5.000. 


by  82  feet  deep,  divided  through  the  centre  by  a  hall  four  feet  wide,  which  is  cut  at  right 
angles  by  the  corridor  leading  to  the  wings.  On  one  side  of  the  hall  are  two  rooms,  for 
private  patients,  11  feet  wide  by  13  feet  deep,  an  operating  and  preparation  room;  on  the 
other  one  private  room,  a  dining  room  16  feet  wide  by  18  feet  deep,  and  a  kitchen  16  feet 
wide  by  13  feet  deep.  The  dimensions  of  the  extension  are  only  approximate,  as  the  rear 
and  sides  of  the  building  are  broken  and  project  in  order  to  give  space  for  the  dining  room 
and  kitchen.  This  building  is  connected  by  a  tunnel  with  the  administration  building 
and  is  heated  from  the  central  plant.  The  capacity  is  for  thirty  patients  at  an  estimated 
cost  of  $20,000. 


Municipal  Sanatorium,  Otisville,  N.  Y.,  Women's  Infir^l\ry  (Illustrations 
59  and  60).  This  building  is  a  two  story  frame  structure  which  rests  on  a  stone  foundation 
and  stone  piers,  with  a  basement  under  the  central  section  25  feet  wide  by  29  feet  deep. 
The  exterior  of  the  building  is  covered  with  shingles,  stained  green,  with  cream  colored 
trimmings  and  the  roof  is  also  of  shingles  stained  a  Tuscan  red.  It  is  88  feet  long  by  16  feet 
wide  through  the  wards,  and  28  feet  through  the  centre,  and  consists  of  a  centre  section 
and  two  wings.  The  first  floor  is  di\ided  into  two  open  wards  for  six  patients  each,  16 
feet  wide  by  27  feet  long,  a  sitting  room  24  feet  wide  by  14  feet  deep,  a  locker  and  dressing 


107 


Section  IV 


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No.    6i.— Eudowood    Sanatorium,    Towson,   Md.      Archer    &    Allen,    Architects.      Infirmary 

Building,     \iews  of  the  Front  and  Rear  Elevations.     Floor  Plans.     Capacity,  30  Patients. 

Estimated  Cost,  $30,000.     (See  illuslration.s  22  and  83  for  further  description  of  this  institution.) 


room  II  feet  wide  by  13  feet  deep,  baths,  toilets  and  attendant's  room  11  feet  wide  by  14 
feet  deep. 

The  second  floor  contains  two  small  open  wards  18  feet  wide  by  16  feet  deep,  two 
sitting  rooms  12  feet  wide  by  14  feet  deep,  a  small  hall  four  feet  wide,  two  dressing  rooms 
with  lockers  10  feet  wide  by  12  feet  deep,  diet  kitchen,  9  feet  wide  by  9  feet  deep,  and  an 
enclosed  infirmary  ward  24  feet  wide  by  14  feet  deep,  situated  over  the  sitting  room  in  the 
centre  of  the  building  with  a  capacity  of  four  patients. 

The  building  has  good  modern  plumbing  throughout  and  is  heated  through  direct 

108 


Hospitals  for  Advanced  Cases,  Infirmaries  and  Reception  Hospitals 


radiators  by  a  steam  heating  plant  in  the  basement  which  also  contains  a  water  tank  for 
supplying  hot  water  for  toilet  purposes.  There  is  no  stairway  connecting  the  two  floors, 
the  upper  story  being  reached  by  a  platform  running  from  a  steep  side  hill  in  the  rear  of 
the  building.  The  front  windows  are  all  arranged  so  that  both  sashes  can  slide  into  pockets, 
lea\-ing  the  openings  entirely  free.  By  this  means  the  infirmary  can  be  changed  when 
desirable  into  an  open  ward.  The  capacity  is  twenty-four  beds,  and  the  cost  of  construction 
was  $5,000. 

Eudowood  Sanatorium,  Towson,  Md.,  Infirmary  Building  (Illustration  61). 
This  is  a  frame  structure,  covered  externally  with  shingles,  resting  on  a  stone  foundation 
and  stone  piers.  It  is  192  feet  long  by  25  feet  wide,  through  the  wards,  and  consists  of  a 
central  section,  two  wings  and  three  rear  extensions.  The  centre  of  the  building  is  two 
stories  with  a  cellar  and  is  designed  after  the  Colonial  style  of  southern  architecture,  36 
feet  wide  by  46  feet  deep  including  the  porch,  but  not  the  rear  extension,  which  is  17  feet 
wide  by  35  feet  deep.  On  the  front  is  a  sitting  room  35  feet  wide  by  16  feet  deep  and  behind 
it  a  hall  four  feet  wide  uniting  the  two  wings,  an  examining  room,  a  linen  closet  and  a  storage 
room.  The  dining  room  is  15  feet  wide  by  21  feet  deep,  partly  in  the  central  section  and 
partly  in  the  rear  extension,  with  a  pantry  15  feet  wide  by  10  feet  deep,  and  a  kitchen  15 
feet  wide  by  14  feet  deep  behind  it.  The  cellar  contains  rooms  for  the  heating  plant  and 
storage  and  the  second  story  four  bedrooms,  closets,  baths,  toilets  and  a  sleeping  porch 
II  feet  wide  by  34  feet  long  for  the  use  of  the  nurses.  The  wings  including  the  private 
rooms  and  porches  at  the  ends  are  98  feet  long  by  25  feet  wide,  and  are  divided  into  two 
wards  for  six  patients  each,  31  feet  long  by  13  feet  deep,  with  a  porch  in  their  front  10  feet 
wide  by  78  feet  long,  three  private  rooms  at  the  outer  ends  each  S  feet  wide  by  10  feet 
deep,  a  private  porch  24  feet  wide  by  8  feet  deep,  and  in  the  rear  an  extension  16  feet  wide 
by  21  feet  deep,  containing  lockers,  toilets  and  baths,  and  a  dressing  room. 

This  building  is  considered  a  model  for  a  good  infirmary  at  a  large  sana- 
torium, wtll  pro\-ided  with  other  buildings.  Twenty-four  patients  are  housed  in 
small  wards;  six  in  private  rooms,  and  all  having  private  alcoves  in  the  dressing 
room.  The  building  is  a  complete  unit,  as  there  are  comfortable  quarters  pro- 
vided for  the  nurses  and  attendants,  a  dining  room,  kitchen,  and  other  necessary  apart- 
ments. The  plans  are  worth  careful  study,  and  the  private  rooms  at  the  ends  of  the 
wings,  with  a  private  porch  which  cannot  be  overlooked  from  the  main  buildings,  should 
be  noted.     The  capacity  is  thirty  beds  and  the  cost  830,000. 

Edward  Sanatorium,  Naperville,  111.,  Infirm.arv  and  Medical  Building 
(Illustration  62 ).  This  is  a  two  story  frame  structure,  on  a  stone  foundation,  painted  white 
and  roofed  with  shingles.  It  is  70  feet  long  by  34  feet  wide  and  has  a  basement  and  an 
unfinished  attic  lighted  by  dormer  windows.  The  basement  contains  a  disinfecting  room 
II  feet  wide  by  14  feet  long,  a  disinfecting  plant  for  sputum  cups,  coal  storage  24  feet  long 
b\- 14  feet  wide,  a  carpenter  shop  9  feet  wide  by  16  feet  long,  a  mortuary  6  feet  wide  by  7  feet 
long,  a  dressing  room  10  feet  wide  by  12  feet  long,  with  two  shower  baths,  and  an  engine 
room  16  feet  wide  by  17  feet  long  for  the  heating  plant,  and  hot  water  tank. 

The  first  floor  is  divided  down  the  centre  by  a  hall  and  contains  a  reception  room 
and  superintendent's  office,  both  11  feet  wide  by  12  feet  long,  a  dressing  room  6  feet 
wide  by  10  feet  long,  a  drug  room  10  feet  wide  by  11  feet  long,  a  diet  kitchen  7  feet  wide 
by  II  feet  long,  and  two  dressing  rooms  for  the  infirmary  patients,  with  toilets,  baths 
and  lockers. 

109 


Section  I\ 


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FIRST  TLHHR    PM>N 


HA5FMb-NT     WL<kN 


No.  62. — Edward  Sanatorium,  Naperville,  111.  Designed  by  Dr.  Theodore  B.  Sachs.  W.  .\.  Otis 
AND  Edwakij  II.  Clark,  .Architects.  Infirmary  and  ^Iedical  Biuldixg.  View  of  Front  and 
Side  Elevations  and  Floor  Pl.ans.  Capacity,  12  Patients.  Cost,  $21,435.  (See  illustrations 
82  and  88  for  further  description  of  this  institution.) 


The  second  story  is  also  divided  by  a  hall  running  through  the  centre  of  the  building 
and  arranged  with  rooms  for  the  superintendent,  physician  and  nurses,  and  two  dressing 
rooms  with  toilets,  baths  and  lockers.  The  infirmary  is  housed  on  two  large  porches 
31  feet  wide  by  18  feet  deep,  one  on  the  first  and  the  other  on  the  second  floor,  facing 
the  south  and  protected  on  the  west  by  windows,  on  the  north  by  the  wall  of  the  building 
and  on  the  south  and  east  by  canvas  curtains.  Each  porch  accommodates  si.x  patients, 
the  lower  for  men  and  the  upper  for  women.     The  building  was  carefully  designed  and 


no 


Hospitals  for  Advanced  Cases,  Infirmaries  and  Reception  Hospitals 


simply  finished  with  round  corners,  smooth  surfaces,  tile  and  cement  floors  and  enameled 

walls.     It  is  heated  by  steam,  well  \-cntilated  and  cost  $21,435. 

Adirondack  Cottage  Sanitarium,  Saranac  Lake,  N.  Y.,  Infirmary  axd 
Medical  Building  (Illustration  63).  This  building  consists  of  a  basement  and  two  stories 
with  walls  of  the  foundation  and  first  story  constructed  of  native  stone  two  feet  thick. 
The  second  story  is  of  frame  with  a  shingled  exterior,  extra  insulation  against  cold  having 
been  obtained  by  using  two  layers  of  paper  and  siding  between  the  shingles  and  interior 
finish,  which  is  plaster  on  wood  lath. 

Its  peculiar  right-angle  shape  is  due  to  the  position  of  the  site,  as  there  was  not 
room  enough  on  the  land  to  place  a  straight  structure.  The  width  of  the  front  is  twenty- 
two  feet  at  the  angle,  and  the  length  of  each  side  on  the  front  is  fifty-three  feet  and  on 
the  rear  forty-six  feet.  The  basement  contains  the  heating  plant,  and  a  store  room  used 
in  connection  with  the  laboratory. 

On  the  first  floor  are  eight  patients'  rooms  9  feet  wide  by  13  feet  deep,  opening  on 
to  a  porch  10  feet  wide  by  60  feet  long,  with  a  corridor  five  feet  wide  in  the  rear;  a  nurses' 


No.  63.— Adirondack  Cottage  Sanitarium,  Saranac  Lake,  N.  Y.  Scopes  &  Feustmann,  ARcmxECTS. 
Infirmary  and  Medical  Building.  \'ii;\v  of  Front  and  Side  Elevations  and  Floor  Plans. 
Capacity,  10  Patients.  Cost.  $26,000.  (See  frontispiece  and  illustrations  13,  98,  104  and  109  for 
further  description  of  this  institution.) 


Ill 


Section  IV 


bedroom  g  feet  wide  by  13  feet  deep,  a  sitting  room  13  feet  wide  by  13  feet  deep  and  a 
nurses'  office  in  the  anj^le  10  feet  wide  at  the  widest  point  and  13  feet  deep.  In  the  corners 
of  this  office  next  to  the  windows  are  mirrors  so  arranged  that  the  nurse  sitting  at  a  desk 
in  the  centre  of  the  room  is  able  to  overlook  both  porches.  In  the  rear  of  the  corridor  are 
lockers,  baths  and  toilets,  a  hall,  stairway  and  the  main  entrance. 

The  second  tioor  is  divided  into  a  laboratory  27  feet  long  by  16  feet  wide,  a  treatment 
room  10  feet  wide  by  13  feet  deep,  an  examination  room  13  feet  wide  by  17  feet  deep,  a 
throat  room  8  feet  wide  by  9  feet  deep,  a  patients'  waiting  room  11  feet  wide  by  18  feet 
deep,  a  drug  room  10  feet  wide  by  13  feet  deep,  an  .v-ray  room  g  feet  wide  by  13  feet  deep, 
a  doctor's  office  14  feet  wide  by  15  feet  deep,  a  statistician's  office  12  feet  wide  by  15  feet 
deep  and  two  porches  11  feet  wide  by  20  feet  deep,  on  which  the  medical  staff  work  on 
pleasant  days. 

In  order  to  economize  on  the  cost  of  construction,  this  structure  was  made  to  combine 
the  purposes  of  an  infirmary,  reception  hospital  and  medical  building.  All  patients  when 
first  arriving  at  the  sanitarium  are  cared  for  on  the  first  floor  while  the  second  floor  is  used 
for  the  work  of  the  medical  and  laboratory  staff.  One  interesting  feature  of  the  building 
is  the  arrangement  of  the  transoms  in  the  patients'  rooms  over  the  roof  of  the  porch. 
This  overcomes  the  disadvantage  of  shutting  out  the  sunlight  when  rooms  are  flanked  by 
a  continuous  porch,  but  it  can  only  be  planned  for  when  patients  are  housed  on  one  floor. 
The  building  has  a  capacity  for  ten  patients  and  cost  $26,000. 

Maryland  State  Sanatorium,  Sabillasville,  Md.,  Infirmary  Building 
(Illustration  64).    This  buflding  is  of  frame  construction,  placed  on  a  stone  foundation,  and 


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No.    64.    Maryland    State    Sanatorium,    Sabillasville,    Md.      Wvatt    &    Xoi.tinc.    Architects. 

Infirmary  Hiildixg.     \'ie\v  of  Front  Elevation,  and   Floor    Plan.     Capacity,   20  Patients. 

Estimated  Cost,  Si8,ooo.     (See  illustrations  3  and  75  for  further  description  of  this  institution.) 


II. 


Hospitals  for  Advanced  Cases,  Infirmaries  and  Reception  Hospitals 


No.  65.— Georgia  State  Sanatorium,  Alto,  Ga.  Scopes  &  Feustmann',  axd  Walter  W.  Judell, 
Associated  Architects.  Infirmary  Building.  View  of  Front  Elevation,  and  Floor  Plan. 
Capacity,  24  Patients.  Cost,  $18,000.  (See  illustrations  4  and  78  for  further  description  of  this 
institution.) 

Stone  piers,  and  covered  on  the  exterior  with  shingles.     It  is  designed  on  the  same  Hnes 
as  the  lean-tos  for  housing  the  incipient  patients  at  this  institution. 

It  consists  of  a  central  section,  two  wings  and  three  small  rear  extensions,  and  is 
195  feet  long  on  the  front.  The  central  section  is  28  feet  wide  by  32  feet  deep,  containing  a 
sitting  room  25  feet  wide  by  18  feet  deep  and  two  small  linen  closets.  The  corridor  runs 
the  full  length  of  the  building  and  in  its  rear  are  three  extensions,  the  one  in  the  centre 
containing  a  nurses'  room  9  feet  wide  by  9  feet  long,  a  diet  kitchen  9  feet  wide  by  16  feet 
long,  and  a  store  room  8  feet  wide  by  9  feet  long.  Those  in  the  rear  of  the  wings  are  36 
feet  deep  by  31  feet  wide  and  contain  the  toilets  and  baths.  The  capacity  is  twenty 
patients  at  an  estimated  cost  of  $15,000. 


Georgia  State  Sanatorium,  Alto,  Ga.,  The  Infirmary  Building  (Illustration 
65).  This  is  a  one  story  building  with  a  basement,  of  frame  construction,  placed  on  a 
foundation  of  local  stone  18  inches  thick.  It  is  covered  with  shingles  on  the  outside, 
having  one  thickness  of  siding  and  building  paper  over  the  studs  and  plastered  on  the  inside 
over  wood  lath.  It  is  150  feet  long  by  25  feet  through  the  ends,  and  37  feet 
wide  through  the  centre  which  is  divided  by  a  large  lounging  hall  12  feet  wide  by  35  feet 
8 


II- 


Section  IV 


long.  This  hall  is  cut  at  a  right-angle  by  a  corridor  7  feet  wide  and  92  feet  long,  uniting 
the  two  wards,  which  are  both  24  feet  wide  by  29  feet  deep  and  have  a  capacity  of  eight 
patients  each.  There  are  sleeping  porches  10  feet  wide  by  34  feet  long,  for  six  patients 
each,  at  the  ends  of  the  building,  a  porch  12  feet  wide  by  41  feet  long  for  eight  patients  on 
the  south,  and  two  porches  both  10  feet  wide  by  20  feet  long,  for  two  patients  each,  on  the 


No.  66.— Danvers  State  Hospital,  Hawthorne,  Mass.     Designed  by  Dr.  F.  Page.     Pavilion;  View 
OF  Front  and  Side  Elevation  and  Floor  Plan.     Capacity,  16  Patients.     Estimated 

Cost,  $6,cxdo. 

114 


Hospitals  for  Advanced  Cases,  Iniirmaries  and  Reception  Hospitals 


No.  67. — Ohio  State  Sanatorium,  Mount  Vernon,  Ohio.     F.  L.  Packard,  Architect.     Reception 

Hospital.     View  of  Front  Fle\  ation  and  Floor  Plan.     Capacity,  24  P.\tients.     Estimated 

Cost,  830,000.     (See  illustration  77  for  further  description  of  this  institution.) 


north.  In  addition  to  the  wards  there  are  six  private  rooms  9  feet  wide  by  13  feet  deep,  and 
conveniently  placed  locker  rooms,  toilets,  baths,  linen  closets  and  a  diet  kitchen.  The 
structure  was  planned  so  that  it  could  be  used  as  a  temporary  administration  building, 
and  then  easily  and  economically  turned  into  a  well  laid-out  infirmary.  The  architect 
designed  the  infirmary  first  and  then  worked  out  the  arrangement  for  administrative  pur- 


11: 


Section  I\' 

poses  for  which  it  is  now  being  used.  The  ward  on  the  east  end  was  converted  into  a 
dining  room  and  the  sleeping  porch  beyond  enclosed  for  a  kitchen  and  pantry,  and  the 
north  porch  enclosed  for  a  staff  dining  room.  The  ward  on  the  west  end  was  cut  down 
to  a  capacity  for  six  patients  and  the  remaining  space  converted  into  sleeping  rooms  for 
two  nurses.  The  balance  of  the  building  as  constructed  will  not  be  changed.  When 
converted  into  an  infirmary  it  will  have  a  capacity  of  twenty-four  patients.  The  cost  of 
construction  was  Si8,ooo. 

Danvers  State  Hospital,  Hawthorne,  Mass.,  Tuberculosis  P.vvilion  (Illus- 
tration 66).  This  pavilion  was  erected  to  house  insane  tuberculous  patients,  but  is  well 
arranged  for  use  as  a  reception  cottage  if  small  observation  wards  are  desired.  It  is  60 
feet  wide  by  ^2  feet  deep,  with  a  rear  extension  35  feet  wide  by  18  feet  deep  and  is  of 
frame  construction,  covered  with  shingles  and  heated  with  steam.  The  pa\'ilion  contains 
a  large,  well  screened  porch  11  feet  wide  by  60  feet  deep,  opening  into  a  dining  room  18 
feet  wide  by  20  feet  deep,  with  two  small  wards  20  feet  wide  by  20  feet  deep,  for  eight 
patients  each,  on  either  side.  At  the  rear  of  the  dining  room  is  an  extension  containing  the 
attendants'  room,  pantry,  toilet  and  bath.  The  arrangement  of  the  porch  is  interesting 
as  it  is  structurally  a  part  of  the  building  and  the  glass  in  the  roof  is  an  unusual  feature. 

The  capacity  is  sixteen  patients,  at  an  estimated  cost  of  $6,ooo. 

Ohio  State  Sanatorium,  Mt.  Vernon,  Ohio,  Reception  Hospit.al  (Illustration 
67).  This  building  is  two  stories  high,  constructed  of  brick,  on  a  concrete  foundation,  with 
white  stone  trimmings,  and  a  tile  roof,  147  feet  long  and  37  feet  through  the  wings.  Both 
stories  have  the  same  general  floor  plan,  consisting  of  a  central  section,  two  wings  and  a 
rear  extension.  In  the  centre  is  a  living  room  31  feet  wide  by  15  feet  deep,  with  a  porch  or 
loggia  on  the  front  31  feet  wide  by  13  feet  deep.  The  wings  are  divided  into  six  single 
rooms  8  feet  wide  by  10  feet  deep,  with  a  corridor  live  feet  wide  at  their  rear  and  a  porch 
or  loggia  12  feet  wide  by  55  feet  long  on  the  front.  The  rear  extension  is  32  feet  wide  by 
59  feet  deep,  divided  by  a  corridor  in  the  centre  six  feet  wide,  with  rooms  on  either  side  used 
for  toilets,  baths,  storage  and  attendants. 

The  building  has  a  number  of  good  features.  It  is  well  constructed  and  the  patients 
are  housed  in  separate  rooms.  The  arrangement  of  the  passageways,  corridors  and  the 
patients'  closets  are  convenient  and  should  be  noted.  It  has  a  capacity  of  twenty-four 
patients  at  an  estimated  cost  of  $20,000. 


116 


SECTION  V 
Patients'  Quarters — Lean-to  Type  of  Building 


Section  V 


K 


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Jil 

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ii8 


SECTION  V 
Patients'  Quarters — Lean-to  Type  of  Building 


This  section  is  a  study  of  the  growth  and  changes  made  in  the  lean-to  type  of  building 
since  it  was  first  adopted  for  housing  incipient  tuberculous  patients.  The  many  modifica- 
tions have  tended  to  increase  the  capacity  rather  than  to  change  the  form.  In  some 
instances  the  expansion  has  been  upwards,  while  in  others  the  porches  have  been  lengthened. 
A  building  of  this  design  can  be  cheaply  constructed  and  has  proven  to  be  comfortable 
and  serviceable  both  when  put  up  in  a  rough  way  for  incipient  cases,  and  when  well  con- 
structed and  finished  on  the  interior  for  advanced  cases. 

Origin  of  the  Lean-to 

The  idea  of  housing  tuberculous  patients  in  lean-tos  was  first  suggested  by  Dr. 
Herbert  M.  King,  of  Loomis  Sanatorium.  He  took  as  his  model  the  old-time  Adirondack 
lean-to  camp,  which  is  usually  built  of  a  framework  of  poles  covered  with  bark,  and  de- 
scribes his  first  building  as  a  shed  with  an  overhanging  roof,  open  in  front,  with  the  ends 
constructed  to  be  opened  or  closed  as  occasion  demands.  In  the  back  wall  were  three 
openings  in  which  were  placed  stationary  slat  blinds,  intended  to  increase  the  circulation 
of  air,  but  which  produced  too  direct  a  draught  for  use  in  winter.  The  building  had  a 
floor  space  12  feet  wide  by  40  feet  long,  giving  room  for  eight  30-inch  beds,  and  was  con- 
structed of  plain  lumber  neither  painted  nor  stained  on  the  interior  and  covered  externally 
with  cedar  shingles.  In  order  to  make  it  serviceable  for  the  winter  it  was  necessary  to  pro- 
vide a  heated  dressing  room  near  at  hand.  This  was  obtained  by  an  addition  placed 
directly  behind  the  lean-to  and  fitted  with  toilets  and  wash  basins  and  heated  by  a 
stove  surrounded  by  a  water  coil  which  provided  hot  water  for  toilet  purposes. 

Later  the  design  for  this  simple  structure  was  modified,  and  a  larger  and  more 
elaborate  building  constructed.  This  consists  of  two  lean-tos  placed  end  to  end,  somewhat 
wider  than  the  original,  and  connected  by  a  sitting  room  for  use  in  bad  weather,  with  a 
double  locker  and  dressing  room  directly  back  of  it  in  an  extension.  The  ad\-antage  ob- 
tained by  this  impro\-ement  over  the  first  building  was  ample  space  for  reclining  chairs  at 
the  foot  of  the  beds,  protected  from  the  weather,  a  warm  sitting  room  and  a  larger  dressing 
apartment. 

In  designing  and  constructing  lean-tos  for  housing  incipient  patients  the  following 
points  should  be  considered. 

Material 

Shall  the  lean-to  be  constructed  with  material  that  will  make  a  fairly  permanent 
and  comfortable  structure?  It  would  seem  as  if  the  funds  available  must  settle  this  ques- 
tion, for  good  results  are  obtained  from  the  open-air  treatment  in  cheap  buildings,  although 
some  of  them  are  only  shacks  without  plumbing  or  heating  arrangements,  where  the 
patients  use  the  old  style  wash-bowl  and  pitcher,  or  go  to  a  small  central   building 

"9 


Section  V 


for  toilet,  washing,  and  bathing  facilities.  During  the  early  stages  of  pulmonary 
tuberculosis,  patients  usually  stand  the  exposure  to  cold  weather  on  the  porches  very 
well  if  they  have  a  heated  ajxirtment  near  at  hand  to  which  they  can  go  for  dressing  and 
toilet  pun)oses  and  in  order  to  get  warm.  The  objection  made  to  cheap  lean-tos  is  that 
they  are  not  substantial,  permanent  buildings,  and  cost  more  to  maintain  in  good  order 
than  the  more  costly  structures.  On  the  other  hand,  it  is  contended  that  they  can  be  torn 
down  and  rebuilt  on  the  same  lines  a  numl)er  of  times  for  less  money  than  it  costs  to  erect  a 
permanent  structure  which  may  become  out-of-date.  There  is  no  doubt  that  a  happy 
mean  exists  between  the  extremes  of  a  shed  with  little  in  the  way  of  comforts,  costing 
$50.00  to  $75.00  per  patient,  and  some  of  the  elaborate  buildings  classed  as  lean-tos  which 
cost  from  $400.00  to  $800.00  per  patient. 

Lean-tos  are  usually  built  of  frame  construction,  consisting  of  a  frame  made 
from  timbers  to  which  sheathing  is  nailed  and  in  turn  covered  externally  with 
shingles  or  one  of  the  patent  board  sidings.  When  well  seasoned  hard  pine  timbers  are 
used  for  the  columns  and  beams  of  the  porch  frame,  and  planks  such  as  are  specified  in  mill 
construction  placed  in  the  floor  and  roof,  the  result  is  a  fairly  substantial  and  perma- 
nent building.  The  roof  is  usually  covered  with  shingles,  but  tin,  slate,  tile  or  one  of  the 
patent  roofing  materials  will  give  good  service. 

Floors 

In  the  sitting  room  the  material  for  the  floors  should  be  hard  wood  or  well  laid  and 
seasoned  ordinary  floor  boards,  covered  with  linoleum.  The  latter  gives  good  satisfaction 
and  rugs  can  be  used  over  it.  In  the  extension  and  dressing  rooms,  a  flooring  should  be 
used  which  will  not  be  affected  by  water,  such  as  one  of  the  composition  materials  in  which 
cement  is  the  predominating  element,  ordinary  cement  flooring,  tile,  terrazzo,  or  a  carefully 


No.  69.— Catawba  Sanatorium,  Catawba,  Va.  Designed  by  Dr.  Kx.mon  V,.  Williams.  \'ie\v  of 
AN  Open  Porch  Illustr-mixg  .\  xMethod  of  Construction  without  Interior  Finish,  and 
A  Manner  of  Protecting  Porches  by  Caw.vs  Ci'rtains  inder  the  Edge  of  the  Roof 
Projection.     (See  illuslralions  17,  30  and  80  for  further  description  of  this  institution.) 


120 


Patients'  Quarters — Lean-to  Type  of  Building 


No.  70. — North  Reading  State  Sanatorium,  North  Reading,  Mass.    Johx  A.  Fox,  Architect.     View 

OF  AX  Open  Porch,  Illustratixg  a  Method  of  Protectixg  Porches  by  Canvas  Curtains  in 

Stormy  Weather.     (See  illustration  87  for  further  description  of  this  institution.) 


laid  board  floor  co\-ered  \vith  battle-ship  linoleum  or  modern  cork,  matting,  glued  down  and 
turned  up  at  the  base  line.     These  last  are  durable,  noiseless  and  non-absorbent. 

Finish 

The  sitting  room  interior  can  be  finished  either  by  sealing  the  walls  and  ceilings  with 
narrow  boards  laid  over  one  or  more  thicknesses  of  building  paper  or  by  plaster  ov^er  wood 
or  metal  lath.  Both  of  these  methods  are  satisfactory;  the  boards  when  used  should  be 
varnished,  or  the  plaster  covered  with  oil  paint. 

In  the  rear  extension  or  dressing  rooms  hard,  smooth  plaster  over  metal  lath  is  a 
good  tinish  and  this  should  be  painted  and  covered  with  coach  varnish,  and  the  walls  for 
about  five  feet  up  from  the  floor  protected  by  tile,  or  imitation  tile  made  of  metal  covered 
by  enamel. 

The  finish  for  the  interior  of  the  porches  depends  upon  individual  taste  and  need  for 
economy.  The  timbers  may  be  left  exposed  in  the  rough,  planed,  painted,  stained,  or 
sealed  with  boards  and  varnished. 


Excavation 

Basements  and  cellars  do  not  aft'ord  the  most  sanitary  means  of  obtaining  storage 
and  extra  room  in  hospital  buildings,  and  excavations  can  be  eliminated  by  raising  lean-tos 
oft"  the  ground  one  to  three  feet  on  stone,  brick  or  concrete  piers.  If  there  is  reason  to  fear 
dampness  a  layer  of  concrete  about  three  inches  thick  should  be  spread  upon  the  ground 
under  the  building. 

Exposure 

The  placing  of  the  building  in  its  relation  to  the  points  of  the  compass  is  important. 
Usually  the  exposure  of  the  porches  should  be  south-east  rather  than  due  south  in  tem- 

121 


Section  V 


perate  climates,  for  since  the  lean-to  has  become  pojiular  it  has  been  found  that  the  air  in 
the  porches  with  direct  southern  exposure  often  gets  exceedingly  hot,  and  sometimes  un- 
bearable during  the  middle  of  the  day  and  the  early  afternoon,  in  the  summer  months,  caus- 
ing the  patients  great  discomfort.  In  hot  countries  and  where  the  summer  temperature 
remains  high  for  hours  at  a  time,  lean-tos  should  have  two  porches  for  each  group  of  pa- 
tients, one  having  a  southern  and  the  other  a  northern  exposure. 

Arrangement  of  Floor  Plans 

In  selecting  a  floor  plan  or  designing  a  new  lean-to,  care  should  be  taken  to  have  the 
rear  extensions  large  enough  to  give  space  for  a  storage  room,  a  linen  closet,  a  warming 
closet  in  which  blankets  can  be  quickly  dried  and  warmed,  and  large  individual  lockers  3 
feet  wide  by  3  to  5  feet  deep..  In  many  of  the  earlier  constructed  lean-tos  the  lockers  are 
often  not  more  than  12  inches  wide  by  12  inches  deep,  too  small  to  allow  any  privacy  to  the 
indi\idual.  It  should  now  be  definitely  understood  that  no  building  for  the  housing  of  in- 
cipient patients  is  complete  unless  it  provides  adequate  facilities  to  each  person  for  privacy. 
The  latest  lean-to  constructed  at  the  Loomis  Sanatorium  is  a  good  illustration  of  one  method 
of  meeting  this  need  with  a  large  locker  or  a  small  private  dressing  room. 

The  arrangement  of  the  porches  is  also  being  modified  in  order  to  reduce  the  number 
of  patients  housed  together.  Large  porches  should  have  partitions  erected  in  order  to 
divide  the  patients  into  small  units.  Two  patients  in  a  small  cubicle  about  10  feet  wide  by 
8  feet  deep  seems  to  be  the  most  satisfactory  arrangement. 

The  rear  walls  in  many  cases  are  too  low.  This  is  a  mistake,  as  it  is  hard  to  ven- 
tilate a  lean-to  built  in  this  manner,  and  causes  the  patients  discomfort  when  moving 
about  quickly.     At  least  eight  feet  in  the  clear  should  be  allowed. 

Porch  Space 

The  width  of  the  floor  space  and  roof  projection  should  be  ample,  as  the  porch 
of  the   lean-to  provides  the  living  quarters  of    the    patients.     Room   to    mo\-e  about 


No.  71.    Virginia   State   Farm,  Richmond,  Va.     \ik\v  of   Open  Porch  Illustrating  Manner  of 
Pkotkctim,  Pdrihes  by  Cawas  Curtains  Placku  between  Pillars,  a  Few  Feet  Back 

FROM  THE  Line  of  the  Roof  Projection. 

122 


Patients'  Quarters — Lean-to  Type  of  Building 


No.  72.— Loomis   Sanatorium,   Liberty,   N.  Y.     View  of    Chapman    Cottage.     Sleeping    Porch; 

Illustrating  Method  of  Construction  and  Interior  Finish,  Using  Narrow  Floor  Boards 

FOR  Sealing.     (See  illustrations  i,  73,  91  and  108  for  further  descriptions  of  this  institution.) 


freely  at  the  foot  of  their  beds  and  a  clear  space  for  a  recHning  chair  are  necessary. 
The  depth  of  the  porch  is  also  one  of  the  best  protections  against  storms  and  high 
winds,  and  should  be  three  times  the  length  of  the  bed,  eighteen  feet  or  more  from 
the  rear  wall  to  the  front  line. 

Porch  Protection 

The  front  of  the  porch  is  usually  protected  by  canvas  curtains  hung  on  rollers,  Japa- 
nese matting,  glass  and  sash  windows  which  can  be  raised  and  lowered,  or  glass  doors  which 
can  be  o])ened  and  closed.  The  rear  and  end  openings  are  generally  protected  by  sliding 
windows  known  as  the  "barn-door"  shutter,  ordinary  glass  and  sash  windows  hung  either 
at  the  side  or  from  the  top,  or  a  frame  covered  with  can\-as  hung  on  hinges  or  on  a  pivot. 

Ventilation 

Ventilation  is  one  of  the  most  important  questions  to  be  considered  when  planning 
lean-tos,  for  it  is  about  as  hard  to  obtain  a  current  of  air  in  a  room  with  an  open  front  as  it 
is  in  a  room  enclosed  by  four  walls.  When  cross-ventilation  is  not  obtained  the  air 
becomes  very  bad  at  the  back  of  the  porches.  This  can  be  i:)revented  if  special  care  is 
taken  to  secure  cross  currents  of  air,  by  windows  cut  in  the  side  and  rear  walls,  or  by  open- 
ings above  the  porch  vooi  which  remo^•e  the  foul  air  close  to  the  ceiling. 

Fixtures  and  Plumbing 

Good  substantial  sanitary  fixtures  should  be  used  in  the  dressing  rooms,  allowing  one 
toilet  and  one  wash-basin  to  every  four,  and  one  shower  or  bath  tub  to  e\'ery  eight  patients. 
Plumbing  should  not  be  installed  in  cheap  lean-tos  in  northern  climates  unless  it  is  well 

123 


Section  \^ 


^A^"'-/;'        V-'-AS^ 


37" 


No.  73.  Loomis  Sanatorium,  Liberty,  N.  Y.  Original  Improved  Lean-to.  Designed  by 
Dr.  Herbert  ^Lwox  Kixc.  \ik\v  of  Front  Elevation  and  Floor  Plan.  Cap.acity, 
16  P.4TIENTS.  Cost,  $1,830.  (See  illustrations  i,  72,  91  and  loS  for  further  description  of  this 
institution.) 


protected,  or  frozen  pipes  will  give  much  trouble  during  the  winter  months.  It  is  not  ad- 
visable to  make  arrangements  for  heating  porches  to  be  used  by  incipient  patients,  as  it 
has  been  found  that  expensive  heating  plants  provided  for  this  purpose  are  rarely  used. 

A  comparison  of  the  various  floor  plans  of  lean-tos  described  in  this  section  is  shown 
in  illustration  6S. 


EXAMPLES  OF  LEAN-TOS 

Loomis  Sanatorium,  Liberty,  N.  Y.,  The  Improved  King  Lean-to  (Illustration 
73).  This  building  is  100  feet  long  by  25  feet  deep,  of  frame  construction,  placed  on  stone 
piers  and  covered  externally  with  cedar  shingles  left  to  weather  stain.  It  is  the  original  struc- 
ture used  as  the  model  for  the  lean-to  type  of  building.  The  sitting  room  in  the  centre  is 
20  feet  wide  by  25  feet  deep,  and  the  dressing  room  directly  back  of  it  is  20  feet  wide  by 
14  feet  deep,  both  being  heated  by  a  large  stove  which  also  sui^plies  hot  water  for  the  baths 
and  hand  basins.    The  interior  finish  of  the  centre  apartment  is  hard  pine,  filled  and  var- 

124 


Patients'  Quarters — Lean-to  Type  of  Building 


nished.  The  length  of  the  porches  is  forty  feet,  the  extent  of  the  roof  projection  twenty  feet, 
which  depth  is  a  great  help  in  keeping  out  a  driving  storm.  They  are  simply  and  cheaply 
constructed,  the  2x4  timbers  supporting  the  walls  and  roof  are  left  uncovered,  and  the 
smooth  surfaces  are  painted  with  the  exception  of  the  floor,  which  is  laid  in  the  ordinary 
way  except  where  exposed  to  the  rain.  In  these  places  it  is  made  of  three  inch  material 
with  one-half  inch  spacing  between  each  plank,  the  edges  being  slightly  rounded,  to  prevent 
curling.  The  building  faces  the  south  and  during  storms  the  porches  are  enclosed  by 
canvas  curtains  on  rollers  which  can  be  raised  or  lowered.  The  building  has  a  capacity 
of  sixteen  beds  and  cost  $1,830. 

Michigan  State  Sanatorium,  Howell,  Mich.,  Le.\n-to  (Illustration  74).  This 
building  is  placed  on  stone  piers,  of  frame  construction,  with  a  shingled  roof,  102  feet  long 
by  25  feet  wide  through  the  wards.  The  rear  extension  is  25  feet  wide  by  19  feet  deep  and 
the  entire  floor  plan  is  similar  to  the  improved  King  lean-to,  but  with  a  dift"erent  arrange- 
ment of  the  lockers,  toilets  and  baths.  The  building  is  also  better  finished  and  more 
substantially  constructed,  having  glass  and  sash  windows  to  enclose  the  wards,  a  large 
terrace  in  front  and  more  commodious  dressing  rooms.  The  capacity  is  sixteen  beds  and 
the  cost  of  construction  was  84,500. 


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No.  74.    Michigan  State  Sanatorixun,  Howell,  Mich.     Malcomson.  Higixbotham  and  Clement, 

Architects.     Lean-to.     \'ie\v  of  Front  Elevation  and  Floor  Plan. 

Capacity,  ib  Patients.     Cost.  S4.500. 


12: 


Section  V 


ft J I ■ 


FLOOB  Plan  of  Shacks. 


No.  75.— Maryland  State  Sanatorium,  Sabillasville,  Md.   Wyatt  &  Xoltixg.  Architects.   Leax-to. 

View   of    Froxt    Elevation.    Floor    Plan    and    Cross-section.     Capacity,    20    Patients. 

Estimated  Cost,  $7,000.     (See  illustrations  3  and  64  for  further  description  of  this  institution.) 


Maryland  State  Sanatorium,  Sabillasville,  Md.,  Le.\x-to  for  Incipient 
Patients  (Illustration  75).  This  building  is  of  frame  construction,  placed  on  brick  piers, 
both  the  roof  and  exterior  walls  being  covered  with  shingles  and  stained.  The  trimmings 
around  the  windows  are  painted  white  and  the  interior  sealed  with  narrow  boards  and 
varnished.  The  structure  is  123  feet  long  by  26  feet  deep  through  the  wings,  which  are 
divided  into  a  ward  for  ten  patients,  16  feet  wide  by  50  feet  long,  with  porches  ten  feet 
wide  on  the  front.  The  rear  extension  is  32  feet  wide  by  30  feet  deep  and  is  divided  into 
three  apartments,  two  dressing  rooms,  14  feet  wide  by  22  feet  long,  arranged  to  give  each 
patient  a  private  dressing  alcove  containing  a  set  of  drawers,  and  space  for  hanging  clothes, 
and  a  toilet  room  31  feet  wide  by  10  feet  deep,  containing  ample  bathing  facilities  as  well 

126 


Patients'  Quarters — Lean-to  Type  of  Building 


as  toilets  and  lavatories.     The  sitting  room  between  the  wards  is  22  feet  wide  by  18  feet 
deep,  finished  in  the  same  manner  as  the  other  parts  of  the  interior. 

There  are  ten  of  these  buildings  grouped  about  an  administration  building,  which 
is  described  in  Section  II  of  this  book.  They  all  face  the  south,  every  room  having  light 
and  air  from  opposite  sides,  and  are  alike  with  the  exception  of  the  finish.  The  wards 
have  a  number  of  windows  in  the  rear  and  side  walls,  and  are  protected  in  front  by  large 
sliding  glass  and  sash  frames  placed  between  the  columns  which  can  be  pushed  up  and  out 
of  the  way  allowing  the  wards  to  become  part  of  the  porches.  These  lean-tos  were  built 
to  house  incipient  tuberculous  cases,  but  they  are  so  well  planned  and  constructed  that 
they  could  be  used  for  advanced  cases.  Institutions  such  as  small  town  or  county  hospitals 
that  need  an  isolated  ward  for  advanced  cases  could  use  this  building  as  a  model,  and  by 


No.  76. — Delaware  State  Sanatorium,  Wilmington,  Del.     J.  &M.  Kennedy,  Architects.    Hebrew 

Society  Lean-to.     \'ie\v  of  Front  Elevation  and  Floor  Plan.     Capacity, 

8  Patients.     Estimated  Cost,  Si, 000. 

127 


Section  V 

(li\'i(ling  the  wings  into  single  rooms  and  using  the  same  interior  iinish,  ol>tain  a  substantial 
pavilion  for  a  comparatively  small  outlay.  The  capacity  is  twenty  patients  and  the  cost 
of  construction  about  $7,000. 

Delaware  State  Sanatorium,  Wilmington,  Del.,  Hebrew  Society's  Lean-to 
(Illustration  76).  This  is  a  frame  building,  on  stone  piers,  covered  externally  with  clap- 
boards and  roofed  with  shingles.  61  feet  long  by  iq  feet  deep,  having  a  rear  extension  14 
feet  wide  by  15  feet  deep.  This  little  building  was  erected  to  house  a  few  patients  of  both 
sexes,  and  is  di\ided  into  a  central  sitting  room  14  feet  wide  by  18  feet  deep,  two  small 


No.  77.     Ohio  State  Sanatorium,  Mt.  Vernon,  Ohio.     F.  L.  Packard,  Architect.     Lean-to.     View 
OF   I'RDXT  Elevation  and   Im.ook   Plan.     Capacity,  20  Patients'.     Estimated  Cost,  $6,500. 
(See  illustration  07  for  further  description  of  this  institution.) 


128 


Patients'  Quarters — Lean-to  Type  of  Building 


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No.  78.— Georgia  State  Sanatorium,  Alto,  Ga.     Scopes  &  Feustmanx,  and  Walter  W.  Judell, 

Associated  Architects.     Design  for  a  Lean-to.     Floor  Plan.     Capacity,  16  P.atients. 

Estimated  Cost, $2,500.    (See  illustrations  4  and  65  for  further  descrijition  of  this  institution.) 


wards  10  feet  wide  by  2^  feet  long,  for  four  patients  each,  one  for  men  and  the  other  for 
women;  with  a  porch  in  front  S  feet  wide  by  23  feet  long,  and  windows  for  ventilating 
the  ward  above  the  roof.  The  rear  extension  is  divided  by  a  solid  partition  into  two  dress- 
ing rooms,  each  containing  four  lockers,  a  toilet  and  a  bath  for  the  use  of  the  patients. 
The  building  has  a  capacity  for  eight  patients  and  the  estimated  cost  is  $1,000. 

Georgia  State  Sanatorium,  Alto,  Ga.,  Lean-to,  Floor  Pl.\n  (Illustration  78). 
This  plan  was  suggested  for  the  lean-tos  to  be  constructed  at  the  Georgia  State  Sanatorium, 
and  was  designed  to  give  each  patient  a  small  private  dressing  room  directly  in  the  rear 
of  his  bed.  The  building  to  be  103  feet  long  by  25  feet  deep,  constructed  of  frame  placed 
on  stone  piers,  divided  into  two  open  wards  16  feet  wide  by  51  feet  long,  a  corridor  4  feet 
wide  by  51  feet  long,  and  sixteen  private  dressing  rooms  each  5  feet  wide  by  3  feet  deep. 
The  extension  at  the  rear  of  the  centre  to  be  21  feet  wide  by  1 7  feet  deep  and  containing 
baths,  toilets  and  lavatories.  This  building  was  planned  to  have  a  capacity  for  sixteen 
patients,  without  a  central  sitting  room,  and  to  cost  about  $2,000. 


Ohio  State  Sanatorium,  Mt.  Vernon,  Ohio,  Lean-to  for  Incipient  Patients 
(Illustration  77).  This  building  is  constructed  of  frame,  placed  on  concrete  piers,  with 
the  exterior  covered  with  shingles,  ha^•ing  white  trimmings.  The  building  is  148  feet 
long  and  24  feet  through  the  wings  and  consists  of  a  central  section,  two  porches 
and  a  rear  extension.  It  was  designed  after  the  lean-to  type  of  structure,  but  has  certain 
deviations  from  the  usual  plans  which  are  worth  considering,  for  it  supplies  all  patients 
with  individual  dressing  alcoves  which  add  greatly  to  their  comfort  and  are  much 
appreciated. 

The  central  section  contains  a  li\'ing  room  25  feet  wide  by  18  feet  deep,  with  a 

corridor  behind  it  connecting  the  two  wings  or  sleeping  porches,  which  are  60  feet  long  by 

24  feet  deep.     The  rear  extension  has  a  floor  i)lan  designed  in  the  shape  of  a  cross  (this 

being  the  unique  feature  of  the  building)  56  feet  deep  by  27  feet  wide;  except  through  the 

9  129 


Section  V 


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No.  79.— New  Haven  County  State  Sanatorium,  Meriden,  Conn.     Foote  &  Townsexd.  Architects. 

l.EAN-Xn.       FruNT    FlEVATIOX    AND     FlouR    PLANS.       XoTE. — THERE    ARE    TWf)  OF  THESE    BuiLDIXGS, 

EACH  Two  Stories  High,  but  with  Slightly  Different  Floor  Plans.     Capacity,  40  Patients. 
Estimated  Cost,  $5,000. 


dressing  room,  which  is  52  feet  wide  by  22  feet  deep,  situated  in  the  centre  and  extending 
out  on  each  side,  making  a  break  in  the  walls  which  increases  the  space  used  for  windows. 
There  are  also  more  rooms  in  the  rear  extension  than  are  usually  planned  for  in  lean-to 
structures,  such  as  a  linen  closet,  diet  kitchen  and  nurses'  room.  The  building  has  a 
capacity  for  twenty  patients  and  the  estimated  cost  is  $6,500. 

130 


Patients'  Quarters — Lean-to  Type  of  Building 


New  Haven  County  State  Sanatorium,  Meriden,  Conn.,  Lean-to  (Illustration 
79).  There  are  two  buildings  of  this  design,  one  at  Huntington,  known  as  Building  No.  3, 
and  the  other  at  Meriden.  They  are  of  frame  construction,  on  stone  piers,  covered  exter- 
nally and  roofed  with  shingles,  two  stories  high  and  both  having  a  front  elevation  practi- 
cally of  the  same  general  appearance,  with  slight  variations  in  the  floor  plans.  The  first  and 
second  floors  of  both  buildings  are  alike  and  consist  of  a  central  section,  two  wings  and  a  rear 
extension,  one  being  98  feet  long  by  16  feet  deep  with  a  rear  extension  17  feet  wide  by  24 
feet  deep;  the  other  129  feet  long  by  15  feet  deep  with  a  rear  extension  23  feet  wide  by  15 
feet  deep.  The  sitting  room  in  the  central  section  of  one  is  20  feet  deep  by  16  feet  wide, 
and  in  the  other  19  feet  wide  by  15  feet  deep.  The  wings  of  both  consist  of  a  single  ward 
with  a  capacity  often  patients,  housed  in  separate  cubicles  8  feet  wide  by  9  feet  deep, 
for  two  patients,  or  for  three,  16  feet  wide  by  9  feet  deep.  The  front  of  the  porches  or 
wards  is  protected  by  canvas  curtains  and  the  rear  walls  pierced  by  windows  to  give 
cross- ventilation.  The  rear  extensions  are  used  as  dressing  rooms  and  contain  individual 
lockers,  wash-bowls,  toilets  and  baths.  These  builcUngs  illustrate  well  the  latest  methods 
of  dividing  the  porches  in  order  to  house  patients  in  small  units.  They  have  a  capacity 
for  forty  patients  at  an  estimated  cost  of  85,000. 

Catawba  Sanatorium,  Catawba,  Va.,  Lean-to  (Illustration  80).  This  is  a 
one  story  frame  building,  covered  with  siding  and  roofed  with  shingles,  on  a  concrete 
foundation,  121  feet  long  by  20  feet  deep,  through  the  wings.     The  wards  or  porches  are 


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No.  80. — Catawba  Sanatorium,  Catawba,  Va.     Designed  by  Dr.  Ennion  G.  Williams.    Le.ax-to. 
\iEw  OF  Front   Ele\ation  and  Floor  Plan.     Capacity,  16   Patients.     Estimated  Cost, 

S2.C00.     (See  illuftrations  17.  30  and  6q  for  further  description  of  this  institution.) 


131 


Section  V 


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No.  8i. — Manitoba  Sanatorium,  Ninette,  Manitoba,  Canada.     Designed  by  Dr.  D.  A.  Stewart. 

Li:ax-to.     \'iew  of  Front  ]">levatiox  and  Floor  Plan.    Capacity,  ^2  Patients.     I->stim.-\ted 
Cost,  $8,000.     (See  illustration  25  for  further  description  of  this  institution.) 


20  feet  wide  by  46  feet  long,  and  the  rear  extension  is  52  feet  long  by  12  feet  deep.  There 
is  a  sitting  room  28  feet  wide  and  15  feet  deep  in  the  centre,  with  a  trunk  room  28  feet  wide 
by  8  feet  deep  back  of  it.  There  are  two  dressing  rooms  19  feet  wide  by  12  feet  deep,  and 
a  small  single  bed  ward  11  feet  wide  by  12  feet  deep  in  the  rear  extension  which  is  very 
conxeniently  arranged.  The  building  has  a  capacity  of  sixteen  patients  and  cost  approxi- 
mately 82,000. 


Manitoba  Sanatorium,  Ninette,  Manitoba,  Canada,  Le.jiN-to  (Illustration  81). 
This  l)uilding  is  placed  on  a  cement  foundation  and  stone  piers,  two  stories  high,  of  frame 
construction,  externally  covered  with  shingles  and  trimmed  with  wood  artistically  painted, 
94  feet  long  by  24  feet  throiigh  the  wings.     The  central  section  is  20  feet  wide  by  22  feet 

132 


Patients'  Quarters — Lean-to  T}'pe  of  Building 


long,  and  contains  a  sitting  room  furnished  with  a  large  fireplace,  and  a  toilet  room  fitted 
with  lavatories  and  baths.  The  wings  of  the  building  are  36  feet  long  by  24  feet  deep, 
divided  into  open  wards  36  feet  long  by  15  feet  deep,  with  a  corridor  and  three  dressing 
rooms  in  their  rear.  Each  floor  is  an  independent  unit  for  twelve  patients  and  the 
building  was  constructed  two  stories  in  height  in  order  to  economize  in  heating,  as 
the  winters  in  Manitoba  are  very  cold.  There  are  two  pavilions  of  the  same  type  at 
this  institution;  the  one  housing  women  is  shown  in  the  illustration.  The  other,  for 
men,  has  a  slightly  different  floor  plan,  with  only  one  large  dressing  room  in  the  rear 
of  the  sleeping  porch.  The  advantage  claimed  for  this  building  is  that  the  dressing 
rooms  are  closer  to  the  patients  and  give  them  more  privacy  than  in  the  usual  lean-to 
type  of  structure.  The  cost  of  the  building  including  its  porportion  of  the  heating  plant, 
installation  of  plumbing,  water  supply  and  sewer  connection  was  $8,000. 


No.  82. — Edward  Sanatorium,  Naperville,  111.     \V.  A.  Otis  and  Edward  H.  Clark,  Architects. 

Lean-to.     \'ie\v  of  Front  Elevation  and  Floor  Plan.     Capacity.  10  Patients.     Estimated 

Cost,  $1,800.     (Sec  illustrations  62  and  88  for  further  description  of  this  institution.) 

133 


Section  V 


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No.  83.— Eudowood  Sanatorium,  Towson,  Md.     Archer  &  Allen,  Architects.    Lean-to.     View 

or  Front  Ele\  ation  and  Floor  Plans.     Capacity,  S   Patients.     Estimated  Cost,  $4,000. 

(See  illustrations  22  and  61  for  further  description  of  this  institution.) 


Edward  Sanatorium,  Naperville,  111.,  Lean-to  (Illustration  82).  Tliis  building 
is  of  frame  construction,  on  brick  piers,  co\-ered  on  the  exterior  and  roofed  with  shingles. 
It  is  643  2  feet  long  by  16  feet  wide,  with  a  rear  extension  i8,U  feet  long  by  11  feet  wide. 
The  front  section  consists  of  one  ward  and  the  building  is  illustrated  to  show  the  method 
of  protecting  its  southern  exposure  and  the  means  used  to  ventilate  through  the  roof. 

134 


Patients'  Quarters — Lean-to  Type  of  Building 


The  north  walls  of  the  ward  are  pierced  by  eight  windows  and  a  door  leading  into  the 
extension  which  is  used  as  a  dressing  room  and  contains  lavatories,  toilets  and  lockers 
for  each  patient.     It  has  a  capacity  of  ten  patients  and  cost  $1,057. 

The  Eudowood  Sanatorium,  Towson,  Md.,  Garrett  Pavilion  or  Lean-to 
(Illustration  83).  This  is  a  frame  structure  raised  on  brick  piers,  covered  externally  with 
stained  shingles  and  trimmed  with  white  paint.  It  is  an  attractive  building,  arranged 
to  receive  the  light  and  air  from  all  sides  through  open  spaces,  between  the  columns  support- 
ing the  roof,  protected  in  stormy  weather  by  canvas  curtains  stretched  on  frames  and 
hung  on  pivots  attached  to  the  posts.  The  front  is  56  feet  long  by  20  feet  deep  and  consists 
of  one  large  room  used  both  for  sleeping  and  living  purposes.  This  opens  into  a  rear 
extension  19  feet  wide  by  24  feet  deep,  provided  with  eight  lockers  (large  enough  to  be  small 
private  dressing  rooms  3  feet  wide  by  5  feet  deep),  two  toilets,  two  baths  and  four  wash- 
basins, the  whole  making  a  comfortable  and  convenient  apartment.  The  building  has  a 
capacity  of  eight  patients  and  cost  $4,000. 

Iowa  State  Sanatorium,  Oakdale,  la..  Lean-to  (Illustration  84).  This  building 
is  of  frame  construction,  covered  externally  with  siding,  roofed  with  shingles,  and  placed 
on  a  stone  foundation.  In  type  it  belongs  to  the  lean-to  group  of  buildings  and  was  intended 
for  incipient  cases,  but  the  wings  are  di\-ided  into  enclosed  rooms  with  sleeping  porches  in 


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No.  84.— Iowa  State  Sanatorium,  Oakdale,  la.     H.  F.  Liebbe,  .\rchitect.    Leax-to,  240  Feet  Long. 

\'iE\v  OF  Front  and  Side  Elevation  and  Floor  Plan.     Capacity.  40  Patients.     Estimated 

Cost,  SS.ooo.     (See  illustrations  24.  29  and  103  for  further  description  of  this  institution.) 

^35 


Section  y 


front.  It  is  240  feci  long  by  24  feet  deep.  The  veranda  is  twelve  I'eet  wide,  enclosed  with 
wire  netting  for  protection  against  Hies  and  moscjuitoes.  It  is  claimed  that  this  building 
has  been  a  success,  but  that  it  should  have  a  larger  central  section  and  a  rear  extension 
so  as  to  give  better  faciUties  for  toilets,  baths  and  locker  rooms.  It  has  a  capacity  for 
forty  patients  and  the  cost  of  construction  was  $8,000. 

The  Municipal  Sanatorium,  Otisville,  N.  Y.,  The  Lean-to  (Illustration  85). 
This  is  a  frame  building  on  stone  i)iers,  105  feet  long  by  18  feet  wide,  covered  with  shingles, 
stained  artistically  and  trimmed  with  white.  The  front  of  the  building  consists  of  a  long 
open  porch  or  ward  divided  into  three  sections  by  half  partitions,  which  do  not  obstruct 
the  view  of  the  entire  porch  from  either  end.  The  rear  extension  is  42  feet  wide  by  10 
feet  deep,  containing  two  dressing  rooms  each  18  feet  wide  by  10  feet  deep,  with  separate 
entrances  from  the  porch.  There  is  a  small  cellar  excavated  under  the  centre  for  a  furnace 
which  heats  the  dressing  rooms.  The  building  has  no  sitting  room  and  should  be  placed 
near  an  amusement  pavilion  or  some  other  structure  having  an  apartment  for  this  purpose. 
Its  peculiar  feature  is  a  break  in  the  roof  projection  at  the  front  in  which  windows  are 
placed  to  ventilate  the  wards  or  porches.  It  has  a  capacity  of  eighteen  patients  at  an 
estimated  cost  of  $4,400. 


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No.  85. — Municipal  Sanatorium,  Otisville,  N.  Y.  Designed  by  Dr.  Hermann  M.  Biggs. 
John  B.  Van  Pelt,  Architect.  Lean-to.  \'iew  of  Front  Elevation,  and  Floor  Plan. 
Capacity,  18  Patients.  Estimated  Cost,  $4,400.  (See  illuslralions  14,  28,  59,  60,  94  and 
loi  for  further  description  of  this  institution.) 

136 


Patients'  Quarters — Lean-to  Type  of  Building 


No.   86. — Association    Sanatorium,  Louisville,  Ky.      I).  X.  Murphy    &    Brother,  Architiccts. 

Lean-to.     \'ie\v  of  Front  Ele\ation  and  Floor  Plan.     Capacity,  12  Patients.     Esti.\iated 

Cost,  $2,750.     (See  illustration  99  for  further  description  of  this  institution.) 


Association  Sanatorium,  Louisville,  Ky.,  Lean-to  for  Women  (Illustration 
86).  This  building  is  50  feet  long  by  36  feet  wide  including  the  porches,  is  of  frame  con- 
struction, placed  on  oak  posts,  and  stands  on  a  steep  hillside.  It  consists  of  a  central 
sitting  room  16  feet  wide  by  16  feet  deep,  with  a  dressing  room  in  its  rear  16  feet  wide  by 
12  feet  deep,  containing  bath  and  toilets.  On  each  side  of  this  section  is  a  dormitory  19 
feet  wide  by  16  feet  deep.  The  building  is  illustrated  to  show  the  interesting  arrangement 
of  its  porches.  On  the  south  is  one  running  along  the  entire  front  of  the  building,  g  feet 
wide  by  56  feet  long,  and  on  the  north  are  two  each  9  feet  wide  by  19  feet  long,  one  on  either 
side  of  the  dressing  rooms.  This  plan  supplies  porches  with  a  southern  exposure  l\)r  winter 
use,  and  a  northern  exposure  when  the  weather  is  too  warm  for  comfort  in  summer.  The 
capacity  of  the  building  is  twelve  patients  and  it  cost  $2,750. 

137 


Section  V 


North  Reading  State  Sanatorium,  North  Reading,  Mass.,  The  Lean-to  (Illus- 
tration 87).  This  building  is  of  frame  construction,  placed  on  stone  piers,  covered  on  the 
exterior  and  roofed  with  shingles.  It  is  one  hundred  and  thirty-six  feet  along  the  front, 
and  is  designed  so  that  both  the  porches  can  be  overlooked  from  the  sitting  room. 
The  length  of  the  wings  is  fifty-eight  feet  on  the  front  and  sixty-seven  feet  on 
the  rear  and  the  width  nineteen  feet  including  the  veranda.  The  central  section 
is  sealed  on  the  interior  and  the  porches  are  left  unfinished.  The  locker  rooms 
are  placed  at  the  inner  ends  of  the  porches  so  as  to  utilize  the  space  of  the 
angles  made  where  the  wings  join  the  centre  apartment.  The  sitting  room  is  24  feet  wide 
by  18  feet  deep  and  the  two  dressing  rooms  are  both  10  feet  wide  by  18  feet  deep,  and 
contain  shower  baths,  toilets  and  wash-basins.  The  roof  of  the  porch  has  a  break  on  the 
front  for  ventilation  purposes,  somewhat  like  that  in  the  roof  of  the  lean-to  at  Otisville 
(illustration  85).  The  veranda  in  front  of  the  sleeping  porches  also  extends  in  front  of  the 
sitting  room,  and  is  a  feature  to  be  noted,  as  it  adds  materially  to  the  floor  space  which 
can  be  used  in  good  weather.  There  are  four  of  these  lean-tos,  all  alike,  put  up  in  connection 
with  other  buildings  for  one  of  the  new  sanatoria  built  by  the  State  Commission  in  Massa- 
chusetts. They  are  very  satisfactory  except  for  the  rear  walls  of  the  porches  which  are 
said  to  be  rather  low.     Their  capacity  is  twenty  patients  and  they  cost  $3,500  each. 


No.  87.— North  Reading  State  Sanatorium,  North  Reading,  Mass.    John  A.  Fox,  .\rchitect. 

LiiAN-T(j.     View  or  Front  Elevation,  Floor  Flan  and  Cross-section. 

Capacity,  20  Patients.     Cost,  $3,500. 

138 


Patients'  Quarters — Lean-to  Type  of  Building 


j^m 


No.  88. — Edward  Sanatorium,  Naperville,  111.  Designed  by  Dr.  Theodore  B.  Sachs.  \V.  A.  Otis 
AND  Edw.ard  H.  Clark,  Architects.  Lean-to.  \'ie\v  of  Front  Elevation  and  Floor  Plan. 
Cap-ACIty.  6  P.\TiENTS.  CosT,  $1,287.  (See  illustrations  62  and  82  for  further  description  of  this 
institution.) 

Edward  Sanatorium,  Naperville,  111.,  Lean-to  (Illustration  88).  This  building 
is  of  frame  construction,  placed  on  cedar  posts,  covered  externally  and  roofed  with  cedar 
shingles.  It  is  52  feet  long  by  22  feet  wide  and  consists  of  an  enclosed  sitting  room  15 
feet  wide  by  10  feet  deep  and  dressing  room  15  feet  wide  by  12  feet  deep,  at  one  end,  from 
which  extends  out  at  a  right  angle  a  porch  or  open  ward  36  feet  wide  by  71  feet  deep.  The 
sitting  room  is  plastered  and  has  three  large  windows  breaking  up  the  south  wall  and  two 
windows  and  a  door  leading  to  the  porch.  The  dressing  room  is  finished  in  the  same 
manner  and  contains  lockers  for  each  patient,  toilets,  baths  and  lavatories.  The  porch 
is  unfinished,  faces  the  south,  has  an  open  front  protected  in  bad  weather  by  canvas 
curtains,  a  large  door  occupying  one-half  of  the  east  wall,  and  two  large  ventilators  in  the 
roof.  It  is  illustrated  to  show  the  means  used  to  ventilate  the  porch;  the  rear  and  side 
walls,  with  the  continuous  row  of  windows  and  the  ventilators  in  the  roof,  should  be  noted. 
The  building  has  a  capacity  for  six  beds  and  cost  81,287. 

139 


Section  V 


No.  89. — Iowa   State  Hospital,  Mt.   Pleasant,   la.     H.   F.  Liebbe,  Architect.     Le.^n-to.     Front 
Elev.atiox  .a^nd  Floor  Plan.     C.-\p.a.city,  12  Patients.     Estimated  Cost,  83,000. 


Iowa  State  Hospital,  Mount  Pleasant,  la.,  Le.\n-to  (Illustration  89).  This 
building  is  planned  on  the  lines  of  a  lean-to,  with  two  wards  on  either  side  of  a  central 
section  which  projects  to  the  rear.  It  is  a  one  story  building  of  frame  construction.  The 
interior  walls  are  sealed  with  yellow  pine  and  finished  in  oil.  The  exterior  is  covered  with 
cedar  shingles  stained  dark  brown  and  trimmed  with  an  ivory  color. 

In  the  centre  of  the  building  is  a  room  15  feet  wide  by  19  feet  deep,  used  both  as  a 
sitting  and  dining  room,  and  extending  out  from  each  side  of  it  is  a  porch  or  open  ward 
37  feet  long  by  14  feet  wide  for  six  patients.  From  the  wards,  on  the  sides  of  the  central 
room,  are  passageways  4  feet  6  inches  wide  by  13  feet  long,  running  back  to  the  dressing 
room,  which  is  10  feet  wide  by  19  feet  long,  and  contains  a  bath  tub,  three  wash-bowls,  a 
toilet  and  a  slop  sink.  On  the  inner  sides  of  both  halls  are  lockers  for  each  patient.  The 
entire  front  of  the  building  is  open,  but  fitted  between  the  pillars  with  sliding  sash  and  glass 
windows  and  frames  for  screens.  The  rear  walls  of  the  wards  also  have  windows  between 
each  bed  in  order  to  produce  cross-ventilation.  The  rear  extension  is  20  feet  deep  by  30 
feet  wide,  well  lighted  by  windows  at  every  available  point,  with  a  cellar  excavated  under 
it,  containing  a  hot  water  heating  y)lant.  In  the  central  room  is  a  brick  fire-place  and  an 
electric  oven  for  reheating  the  food  sent  in  from  the  service  building,  before  it  is  served 
to  the  patients.     It  also  has  windows  on  the  front  above  the  porch  giving  sunlight  to  the 

140 


Patients'  Quarters — Lean-to  Type  of  Building 

room  and  ventilation  near  the  ceiling.  The  cost  of  the  building  complete,  constructed 
to  house  twelve  patients,  was  $3,000,  but  the  capacity  can  be  enlarged  at  small  expense 
if  desired,  by  adding  rooms  at  the  end  of  each  ward.  Attention  should  be  called  to  the 
situation  of  the  combination  sitting  and  dining  room,  the  placing  of  the  lockers  in  halls 
on  its  sides  and  the  porch  space  in  front  of  the  central  room,  used  as  a  vestibule  to  the 
wards,  as  it  is  a  new  arrangement  of  a  floor  plan  for  the  lean-to  type  of  building. 

Rush  Hospital,  Country  Branch,  Malvern,  Pa.,  Lean-to  (Illustration  90). 
This  is  a  frame  building  of  very  cheap  construction,  placed  on  concrete  piers,  and  covered 
by  a  composition  roofing.  It  is  two  stories  high,  53  feet  long  by  12  feet  deep,  with  a  small 
portion  of  the  first  floor,  7  feet  wide  by  18  feet  long,  enclosed  for  a  dressing  room  and 
containing  lockers,  lavatories  and  toilets.  The  balance  of  the  ground  floor  is  used  by 
patients  for  a  lounging  and  sitting  room.  The  second  floor  is  an  open  ward  housing  the 
beds.  The  front  of  the  building  on  both  stories  is  boarded  up  from  the  floor  four  feet,  and 
cross-ventilation  is  obtained  by  windows  in  the  rear  wall.  This  structure  is  practically  a 
two  story  shed  facing  the  south  and  is  one  of  the  cheapest  methods  of  housing  tuberculous 
patients.     It  has  a  capacity  of  seven  beds  at  an  estimated  cost  of  S400. 


4^ 


^■IK.ST   ^■|nllK    HI  AN 
No.   90.     Rush  Hospital,   Country  Branch,  Malvern,   Pa.      Brookie    &    Hastings.  Arciutects. 
Lean-to.     \ie\v  of  Front  Elenation  and  Floor  Plans.     Capacity.  7  Patients.     Estimated 
Cost,  S400.     (See  illustration  97  for  further  description  of  this  institution.) 

141 


Section  V 


No.  91. — Loomis  Sanatorium,  Liberty,  N.  Y.     Designed  by  Dr.  Herbert  AIaxox  King.     Lean-to. 

\'iEW  OF  Front  Elevation  and  Floor  Pl.an.     Capacity,  8  Patients.     Estimated  Cost, 

Si.ooo.     (See  illustrations  i,  72,  73  and  108  for  further  description  of  this  institution.) 

Loomis  Sanatorium,  Liberty,  N.  Y.,  Lean-to  (Illustration  91).  This 
building  is  of  frame  construction,  placed  on  stone  piers,  covered  externally  with 
siding  and  has  a  shingled  roof.  It  is  Dr.  King's  latest  modification  of  a  lean-to  build- 
ing and  is  70  feet  long  by  20  feet  wide,  divided  into  an  open  porch  20  feet  wide 
by  48  feet  long  at  one  end,  and  an  enclosed  apartment  20  feet  wide  by  21  feet  long  at  the 
other.  There  are  lockers  or  small  pri\-ate  dressing  rooms  3  feet  wide  by  5  feet  deep,  for 
each  patient,  toilets,  baths,  and  a  central  dressing  hall  between  the  rows  of  lockers.  The 
enclosed  apartment  is  heated  by  a  large  coal  stove  with  boiler  attachment  to  supply  hot 
water  for  toilet  purposes.    It  has  a  capacity  for  eight  patients  at  an  estimated  cost  of  82,000. 


Michigan  State  Sanatorium,  Howell,  Mich.,  Le.\x-to,  Floor  Plan  (Illustration 
92).  This  was  a  design  made  for  a  lean-to  at  the  2^Iichigan  State  Sanatorium,  but  has  not 
been  constructed.  The  builchng  was  to  have  been  of  frame,  100  feet  long  by  25  feet  deep, 
with  sitting  room  15  feet  wide  by  25  feet  deep  in  the  centre,  the  porches  to  be  42  feet  long 
by  24  feet  deep,  divided  into  an  open  ward  with  four  dressing  rooms  in  its  rear;  these  rooms 
to  be  for  two  patients  each,  <S  feet  wide  by  10  feet  deep,  fitted  with  lockers,  showers,  toilets 

142 


Patients'  Quarters — Lean-to  Type  of  Building 


J  1^1  b 


^bcvj 


^^^ 


T^tOOt    PJ.I*'^ 


j^^mJp; 


No.  82. — Michigan  State  Sanatorium,  Howell,  Mich.     Scopes  &  Feustmaxx,  Architects.     Design 
FOR  A  Leax-to.     Floor  Plax.     Capacity,  iO  Patiexts.     Estimated  Cost,  83,500.     (See  illus- 
tration 74  for  further  description  of  this  insitution.) 

and  wash-basins  and  heated  from  a  central  plant.  The  design  is  worth  studying  and  would 
make  a  convenient  building  for  a  site  on  a  side  hill  as  there  is  no  rear  extension  in  the  plan. 
The  capacity  is  sixteen  patients  at  an  estimated  cost  of  83,500. 

New  York  State  Hospital,  Raybrook,  N.  Y.,  Lean-to  for  Women  (Illustration 
93).  This  floor  plan  was  designed  for  a  lean-to  at  Raybrook,  but  has  not  yet  been  erected. 
It  is  to  be  constructed  either  of  brick  or  frame  and  will  consist  of  a  central  section,  two 
wings  and  a  rear  extension.  In  order  to  make  the  dressing  rooms  in  the  rear  extension 
more  accessible  for  the  patients  in  the  wards,  the  wings  are  designed  to  form  an  acute 
angle  in  the  rear  of  the  building,  at  their  junction  with  the  central  section.  The  wards  are 
fifty-four  feet  long  on  the  front,  forty-six  feet  long  on  the  rear  and  thirteen  feet  wide  opening 
on  to  a  veranda  nine  feet  wide  which  extends  along  the  entire  front  of  the  building.  The 
central  sitting  room  is  27  feet  wide  by  11  feet  deep  and  has  a  large,  open  fire-place.  Behind 
it  is  a  rear  extension  28  feet  wide  by  18  feet  deep,  divided  into  a  linen  room,  toilet  room, 
bathroom,  dressing  and  locker  room.  The  plan  should  be  noted  for  the  arrangements 
made  in  the  wards  to  protect  the  head  of  the  beds,  by  a  half  partition  which  extends  about 
three  feet  in  the  wards.  The  building  has  a  capacity  for  sixteen  patients  and  will  cost 
about  $3,500. 


No.  93. — New  York  State  Hospital,  Raybrook,  N.  Y.     Fraxklix  B.  Ware.  Architect.     Design  for  a 
Leax-to.     Floor  Plax.     Capacity,  iO  Patiexts.     Estim.\ted  Cost,  $3,500. 


143 


Section  \' 


■       ■ 


No.  94.— Municipal  Sanatorium,  Otisville,  N.  Y.  Designed  by  Dr.  Hermann  M.  Biggs.  J.ames  D. 
Blrt,  Architect.  Lean-to,  Xo.  103.  View  of  Front  Elevation  .and  Floor  Pl.ans.  The 
Special  Fe.ature  of  this  Building  is  .a.n  Arrangement  that  Forms  the  P.atients  into  Groups 
OR  Units  by  Supplying  a  Sep.arate  Living  Room  and  Toilet  Apartment  in  Connection  with 
Each  Porch.  Capacity,  32  P.atients.  Cost.  $9,000.  (See  Illustrations  14,  28,  59.  60,  85  and  loi 
for  further  description  of  this  institution.) 


Municipal  Sanatorium,  Otisville,  N.  Y.  Lean-to,  No.  103.  (Illustration  94.) 
This  is  a  two  story  building,  with  foundations  of  native  stone,  eighteen  inches  thick.  The 
walls  are  of  frame  construction,  covered  on  the  outside  with  shingles,  stained  a  dark 
green  and  trimmed  white.  The  roof  is  also  of  shingles  stained  red.  The  interior  is  ceiled 
with  matched  and  fitted  boards,  and  the  floors  are  of  wood,  all  finished  in  oil.  The 
plan  of  the  building  follows  the  general  lines  of  the  lean-to,  but  its  special  feature  is 
an  arrangement  that  forms  the  patients  into  groups  or  units  by  supplying  a  separate 
living  room  and  toilet  apartment  in  connection  with  each  porch.  All  the  patients  have 
private  dressing  rooms  built  with  low  partitions,  and  i)ro\ided  with  lock  doors.  The 
basement  contains  the  heating  apparatus,  toilets,  baths,  blanket  store  rooms,  and  a  recrea- 
tion room  which  is  almost  above  the  ground.  Over  the  centre  is  an  attic  divided  into 
rooms  which  can  be  locked  and  are  fitted  with  open  shelves  where  trunks,  dress-suit  cases 
and  other  belongings  of  the  patients  can  be  stored,  l^ach  wing  is  provided  with  a  fire 
escape  in  the  rear.  The  open  front  faces  the  south,  and  is  furnished  with  roll  curtains 
for  protection  in  rough  weather.  This  building  has  a  capacity  of  thirty-two  patients,  in 
four  groups  of  eight  persons  to  each  porch  and  cost  about  $9,000. 


144 


Patients'  Quarters — Lean-to  Type  of  Building 


^QUTH  ELZVATION    DOEMITOEY  BUILDIMaJM£l 


TTE5T  FTOOP  DOPMlTOITTr  BUlLDinC 


No  05.— Preventorium  for  Children,  Famiingdale,  N.  J.  Designed  by  Dr.  Hermann  M.  Hic.f.s. 
Scopes  &  Feustmaxn,  and  Wai.tkk  W.  |i  dki.l.  Associated  Architects.  Leax-to.  Front  P.leva- 
Tiox  AND  Floor  Plans.  Capacity,  28  Children  and  T\V()  .Vttendants.  Estimated  Cost,  S7.700. 
(See  illustrations  12,  iq  and  27  for  further  description  of  this  institution.) 


The  Preventorium  for  Children,  Farmingdale,  N.  J.,  Dormitory  Biildino 
(Illustration  95).  Modilied  from  the  design  oi  the  shack  lor  chiklren  at  Municipal 
Sanatorium  at  Otisville.  The  e.xterior  walls  of  these  pavilions  are  constructed  of  hol- 
low tile,  covered  with  cement  stucco,  and  are  placed  on  a  concrete  foundation  and 
concrete  piers.  The  interiors  are  of  frame  construction,  with  floors  of  edge-grain  yellow 
pine,  and  the  roofs  are  covered  with  shingles.  There  are  four  of  these  buildings,  all  alike, 
except  the  second  floors  of  the  central  sections.  The  basements  contain  bathing  facilities, 
and  the  wings  are  arranged  as  sleeping  wards,  with  open  fronts,  ceilings  eight  feet  high,  and 

145 


TO 


Section  V 

windows  in  the  rear  walls.  The  dressin<f  rooms  in  the  centre  sections  are  furnished  around 
the  walls  with  benches  divided  into  individual  lockers,  used  to  store  the  toys  and  personal 
belongings  of  the  children.  Over  these  benches,  at  a  height  of  five  and  one-half  feet,  are 
two  shelves  where  the  blankets  used  during  the  rest  hour  ari'  placed.  On  the  rear  walls 
are  racks  to  hold  toilet  articles  and  in  the  centre  is  a  stone  wash-trough  with  hot  and  cold 
W'ater  faucets.  Behind  the  dressing  rooms  are  store  rooms  fitted  with  large  pigeon-holes 
used  instead  of  lockers,  and  the  toilets  arranged  to  be  entered  from  the  rear  direct  from 
the  grounds  and  playrooms  without  tracking  mud  through  the  dressing  rooms  or  wards. 

In  two  pavilions  the  second  stories  consist  of  one  large  play  and  school  room, 
which  can  be  entirely  opened  on  three  sides,  and  accommodates  fifty-six  children. 

In  the  other  buildings  the  second  stories  are  used  as  infirmaries,  divided  into  two 
wards  for  four  children  each,  with  a  porch  on  the  south  to  which  the  beds  can  be  wheeled, 
a  nurses'  room,  a  bath,  a  diet  kitchen  and  a  linen  room.  The  pavilions  have  a  capacity 
for  twenty-eight  patients  each,  and  cost  $7,700. 


146 


SECTION  VI 
Patients'  Quarters — Cottage  Type  of  Building 


SECTION  \T 
Patients'  Quarters    Cottage  Type  of  Building 


Origin  of  the  Cottage 

In  most  of  the  large  private  sanatoria  it  has  been  found  that  the  lean-to  type  of  build- 
ing is  not  satisfactory  for  housing  patients  who  are  willing  to  pay  for  good  nursing  and 
attendance.  Well-to-do  patients  usually  desire  separate  apartments,  and  often  demand  a 
porch  which  is  private  and  cannot  be  overlooked  by  other  inmates  of  the  institution.  In  this 
section  will  be  found  descriptions  of  cottages  which  have  proven  satisfactory,  arranged  to 
house  from  one  to  eight  patients,  with  a  private  room,  separate  porch,  and  all  modern 
toilet  facilities  for  each;  also  cottages  designed  to  be  used  as  a  separate  unit  to  accommo- 
date families  where  one  or  more  members  are  tuberculous,  and  having  rooms  for  a  private 
nurse  and  servants.  Cottages  planned  for  the  use  of  one  person  only,  usually  have  but  two 
rooms,  one  for  dressing  and  toilet  purposes  and  the  other  practically  an  open  sleeping  and 
living  porch.  This  type  of  cottage  is  generally  a  moditication  of  the  original  structure 
designed  by  Dr.  Millet  and  can  be  built  for  a  reasonable  figure. 

It  is  reported  that  in  many  instances  patients  at  large  public  institutions  are  more 
contented  and  imprb\'e  faster  when  gi^'en  a  separate  room  or  a  share  in  a  small  building 
with  one  or  more  congenial  associates,  and  as  some  of  the  cottages  described  are  \'ery 
inexpensive  a  more  careful  study  of  the  results  obtained  by  the  different  methods  of  housing 
incipient  patients,  may  in  the  future  cause  the  construction  of  a  larger  proportion  of  the 
cottage  type  of  sanatorium  in  the  place  of  ward  buildings,  for  state  and  county  tuberculosis 
hospitals. 

Planning  Cottage 

In  designing  and  constructing  cottages  the  following  points  should  be  considered. 

First:  Each  patient  should  have  a  private  room  and  a  porch  which,  when  desired, 
can  be  screened  in  a  way  to  prevent  it  being  overlooked. 

Second:  Cottages  should  be  designed  when  possible  to  conform  to  the  desires  and 
customs  of  the  people  who  will  use  them. 

Third:  The  buildings  should  be  constructed  of  such  material  as  will  make  them 
comfortable  at  all  seasons  of  the  year  in  the  climate  for  which  they  are  intended. 

Fourth:  The  interior  should  be  finished  in  the  most  simple  manner  and  with  smooth 
surfaces  in  order  to  eliminate  places  likely  to  collect  dust. 

Fifth:  The  sleeping  apartment  should  be  as  much  like  an  open  porch  as  possible, 
or  ventilated  in  a  manner  that  can  be  regulated  by  an  attendant,  but  will  prevent  the 
patient  from  shutting  off  the  current  of  air. 


EXAMPLES  OF  COTTAGES 

The  Millet  Sanatorium,  East  Bridgewater,  Mass.,  Cott.age  (Illustration  96). 
This  is  a  frame  building  supported  on  cedar  posts,  boarded  and  covered  with  shingles. 

148 


Patients'  Quarters — Cottage  Type  of  Building 


W^ 


.J»:.'»*C-'.       * 


■  E'L-Erv/^vTl  OH"— 


No.  96.— Millet  Sanatorium,  East  Bridgewater,  Mass.     Design  by  Dr.  C.  S.  Millet 
\'iEw  OF  Front  Elevation,  Floor  Plan,  Side  and  End  Elevation.     C.ap.acity, 
I  Patient.     Estimated  Cost,  S200. 


Cottage. 


The  roof  is  laid  at  "quarter  pitch"  with  the  rise  to  the  front.  There  is  no  plastering  or 
other  interior  finish,  but  the  floor  is  laid  double  with  the  upper  layer  of  narrow,  hard  pine. 
The  cottage  is  12  feet  wide  by  18  feet  long,  divided  by  a  partition  into  a  bedroom  12  feet 
wide  by  12  feet  long,  open  on  all  sides,  and  a  dressing  room  6  feet  wide  by  12  feet  long, 
ligrhted  bv  two  windows,  heated  bv  a  stove  and  furnished  with  a  stationary  wash-stand, 
running  water,  a  toilet  and  a  wardrobe.  The  rear  wall  is  six  and  one-half  feet  high,  and 
faces  the  north  and  can  be  opened  or  closed  by  wooden  shutters.  The  building  is  in- 
tended for  one  person  and  cost  about  S200.00. 

149 


Section  VI 


No.  97.— Rush  Hospital,  Country  Branch,  Malvern,  Pa.     Brookie  &  Hastings,  Architects. 

Cottage.     \'ie\v  of  Front  and  Side  Elevations,  and  Floor  Plan. 

Capacity,  2  Patients     Estim.ated  Cost,  S400. 


Rush  Hospital,  Country  Branch,  Malvern,  Pa.,  Cottage  (Illustration  97). 
This  is  a  small  frame  building  placed  on  4  x  4  timber  posts  and  roofed  with  patent  roofing 
paper.  It  is  18  feet  wide  by  24  feet  long  and  has  a  porch  eight  feet  wide  at  one  end.  The 
building  is  divided  into  two  bedrooms,  each  8  feet  wide  by  15  feet  long,  and  a  dressing  room 
16  feet  wide  by  7  feet  deep.  The  bedrooms  can  be  thrown  into  one  large  room  by  removing 
the  portable  partition  between  them.  The  arrangement  of  the  windows  for  throwing 
open  the  interior  should  be  noted.  This  little  building  is  well  designed  for  cheap  and 
simple  housing.     The  capacity  is  two  patients  and  estimated  cost  of  construction  S300.00. 

150 


Patients'  Quarters — Cottage  Type  of  Building 


No.  98. — Adirondack  Cottage  Sanitarium,  Saranac  Lake,  N.  Y.     Cottage.     \ii:\v  of  Front 
Elevation  and  Floor  Plan.     Capacity,  4  Patients.     Estim.vted  Cost,  S400. 


Adirondack  Cottage  Sanitarium,  Saranac  Lake,  N.  Y.  (Illustration  98).  This 
building  is  placed  on  stone  piers  and  is  of  frame  construction,  33  feet  wide  by  19  feet  deep. 
It  was  built  of  second-hand  lumber  and  other  material  obtained  from  older  buildings  which 
had  been  torn  down  and  was  one  of  the  first  experiments  in  shack  construction  at  this 
Sanitarium.  As  the  patients  at  this  institution  are  given  as  much  privacy  as  possible, 
the  porch  is  divided  into  small  cubicles,  and  the  partitions  between  the  patients'  beds 
are  erected  to  a  height  of  six  feet. 

The  dressing  room  is  heated  by  a  stove,  but  the  toilet  faciUties  are  provided  in 
another  building.     It  has  a  capacity  of  four  patients  at  an  estimated  cost  of  S400.00. 


Section  \l 


No.  99. — Association  Sanatorium,  Louisville,  Ky.      I).  X.  Murphy  &  Brother.  Architects. 
Cottage.     \'ie\v  of  Front  and  Side  Elevation  and  Floor  Pl.an.    Capacity,  12  Patients. 

Estimated  Cost,  $2,250. 


Association  Sanatorium,  Louisville,  Ky.,  Men's  Cottage  (Illustration  99). 
This  is  a  frame  cottage  on  concrete  piers,  covered  \vith  a  patent  roofing,  36  feet  \vide 
by  22  feet  deep,  without  the  porch  or  the  extension.  It  consists  of  a  central  sitting 
room  10  feet  wide  by  15  feet  long,  and  four  private  rooms,  two  10  feet  wide  by  12  feet  deep 
and  two  12  feet  wide  by  14  feet  deep.  The  toilets  and  lavatories  are  in  the  rear  extension, 
which  is  13  feet  wide  by  7  feet  deep,  and  the  building  is  surrounded  on  three  sides  by  a 
porch  twelve  feet  wide.  The  floor  plan  of  this  building  is  very  much  like  the  cottages  at  the 
Iowa  State  Sanatorium,  and  for  some  purposes  is  an  improvement  over  them  because  of 
the  private  rooms.     It  has  a  capacity  for  twelve  patients  and  cost  $2,250. 


IS2 


Patients'  Quarters — Cottage  Type  of  Building 


No.   100. — White  Haven   Sanatorium,  White  Haven,   Pa.     Cottage,     \ie\v  of   Front  and  Side 
Ele\ation  and  Floor  Plan.     Capacity,  S  Patients.     Estim.a.ted  Cost,  SSoo. 

The  White  Haven  Sanatorium,  White  Haven,  Pa.,  Cottage  (Illustration  loo). 
This  building,  placed  on  wooden  ()osls,  is  of  a  cheap  frame  construction,  covered  e.xternally 
with  siding  and  roofed  with  composition  rooting.  There  are  two  open  air  rooms  15  feet 
wide  by  16  feet  long,  protected  by  glass  and  sash  windows  in  winter  and  canvas  curtains 
in  summer,  both  hung  from  the  top.  The  two  pavilions  house  eight  patients  and  are 
connected  by  a  dressing  room  7  feet  wide  by  10  feet  long,  which  is  heated  by  a  small  stove 
and  used  in  common  by  all.  This  plan  for  a  cottage  may  be  constructed  to  house  only  one 
or  two  patients  in  each  pavilion,  when  all  the  dimensions  except  the  size  of  the  dressing 
room  should  be  cut  down.     The  estimated  cost  is  S800.00. 


153 


Section  VI 


1 1  ElUPlEl 


^fftjna  PtoTf 


No.    loi. — Municipal    Sanatorium,    Otisville,    N.    Y.    Designed    by    Dr.    Hermann    M.    Biggs. 
Cottage.     View  of  Front  Elev.ation  and  Floor  Pl.an.     Cap.a.city,  8  P.atients. 

ESTIM.A.TED  Cost,  $1,500. 


The  Municipal  Sanatorium,  Otisville,  N.  Y.,  Cottage  (Illustration  loi). 
This  is  a  frame  building  on  brick  piers,  covered  with  shingles  artistically  stained  and 
trimmed  and  has  a  very  attractive  appearance.  It  is  58  feet  long  by  19  feet  wide  with  a 
sitting  room  in  the  centre  15  feet  wide  by  19  feet  deep,  which  contains  the  patients'  lockers 
and  a  fireplace.  The  porches,  20  feet  wide  by  19  feet  deep,  are  divided  by  a  partition  eight 
feet  high,  into  two  rooms  10  feet  wide  by  12  feet  deep,  for  two  patients  each.  The  verandas 
in  front  of  the  porch  rooms  are  six  feet  wide.  There  are  no  toilets,  baths  or  dressing 
room,  as  this  cottage  is  used  in  connection  with  another  building  containing  a  central 
toilet  and  washroom.  As  it  is  a  cheaply  constructed  building  with  a  floor  plan  easy 
to  remodel  it  may  be  used  by  small  communities  who  wish  to  add  a  pavilion  to  their  local 
hospital  for  housing  tuberculous  patients.     The  estimated  cost  is  vSi  200.00. 

154 


Patients'  Quarters — Cottage  Type  of  Building 


t 


No.  102.— Plainfield  General  Hospital,  Plainfield,  N.  J.  A.  L.  C.  Marsh.  Architect.  Cottage 
Ward  for  Tuberculous  Patients.  \'ie\v  of  Front  and  Side  Elevation.  Floor  Plan.  Capacity, 
8  Patients.  Estimated  Cost,  $3,000.  Xote. — This  is  a  Modified  Plan  of  the  Municip.al 
Sanatorium  Cottage. 


Plainfield  General  Hospital,  Plainfield,  N.  J.,  Cott.\ge  W.a.rd  for  Tubkr- 
CULOUS  Patients  (Illustration  102).  This  building  is  a  design  modilied  from  the  plans  of 
the  Otisville  Cottage.  It  is  si.xty-eight  feet  long,  of  frame  construction,  covered  with  shingles 
and  placed  on  stone  piers.  There  is  a  solid  partition  running  directly  through  the  centre 
dividing  the  two  sides  of  the  building  into  two  separate  sections,  making  two  sitting  rooms 
13  feet  wide  by  ig  feet  long  on  the  front,  and  two  dressing  rooms  8  feet  wide  by  12  feet 
long  in  the  rear.  The  elevation  has  a  slightly  different  arrangement  for  the  windows  in  the 
centre  of  the  building  and  is  supported  by  large  round  columns  which  gives  it  a  very 
attractive  appearance.     The  capacity  is  eight  patients  at  an  estimated  cost  of  $3,000. 


Section  VI 


.fl-TTIN!-!-      r^LitV^ 


I 


;  < 


L J 


I I 


■  7^U,Vi.-^ti- 


^f    o 


I  I 


^^=^ 


:FF^ 


I      I 


No.  103. — Iowa  State  Sanatorium,  Oakdale,  la.  Design  by  Dr.  II.  E.  Kiksciiner.  H.  F.  Liebbe, 
Architect.  Cott.ac.e.  \'ik\v  of  Front  .\xd  Side  Elev.ation  .\nd  Floor  Plan.  C.'^p.^city, 
8  P.\tikxts.  Estimated  Cost,  $1,500.  (Sec  illustrations  24,  29  and  84  for  further  description  of  this 
institution.) 


1.^6 


Patients'  Quarters — Cottage  Type  of  Building 


Iowa  State  Sanatorium,  Oakdale,  la.,  Cottage  (Illustration  103).  This  cot- 
tage, placed  on  brick  piers,  is  of  frame  construction  with  a  shingle  roof.  It  consists  of  a 
large  central  sitting  room  17  feet  wide  by  15  feet  deep,  about  which  is  built  a  twelve  foot 
wide  porch.  In  the  rear  is  a  dressing  room  17  feet  wide  by  9  feet  deep,  containing 
lockers  and  toilet  facilities,  which  receives  plenty  of  sunlight  as  it  is  not  enclosed  by  the 
porch.  The  building  was  planned  for  ten  patients  but  is  more  comfortable  when  only 
housing  eight.  It  is  claimed  for  this  structure  that  part  of  the  porch  will  always  be  shel- 
tered from  storms  and  will  receive  sunlight  from  some  direction  during  the  entire  day. 
Those  who  have  used  the  design  speak  very  highly  of  the  arrangement,  as  there  is  room 
for  all  the  beds  on  the  sheltered  side,  and  it  is  not  necessary  to  enclose  a  portion  of  the 
porch  as  is  done  where  there  is  only  one  exposure. 

Larger  lockers  should  be  placed  in  the  dressing  room  and  better  toilet  facilities 
provided,  such  as  a  shower  bath  and  extra  toilets.  At  the  Iowa  State  Sanatorium  this 
cottage  has  been  very  satisfactory  and  ten  of  a  like  design  ha\-e  been  erected  at  a  cost  of 
about  $1,400  each. 


Adirondack  Cottage  Sani- 
tarium,   Saranac    Lake,    N.     Y., 

Wheeler  Cottage  (Illustration  104). 

This  cottage  is  placed  on  a 
foundation  of  native  stone  and  is  of 
frame  construction,  covered  witli  a 
four  inch  brick  veneer  externally, 
leaving  an  air  space  i  inch  wide  be- 
tween the  brick  and  the  sheathing. 

This  method  of  construction 
was  adopted  in  order  to  make  a  warm, 
dry  building,  and  to  save  repairs  and 
paint  on  the  exterior.  The  roof  is  of 
blocked  tin.  On  the  interior  walls 
and  ceilings  are  finished  in  plaster  on 
wood  lath  with  hard  wood  trimming, 
hard  wood  floors  and  co\-ed  bases  with 
flush  joints. 

Everything  in  this  building  has 
been  arranged  in  a  compact  form. 
There  is  direct  sunlight  in  the  sleeping 
rooms,  which  are  small,  hut  contain 
a  closet,  ventilators  and  are  connected 
with  a  private  porch  for  each  patient. 
The  cottage  consists  of  only  one  story, 
but  has  a  cellar  under  the  entire  build- 
ing which  contains  a  hot  water  heating 
apparatus.  It  has  a  capacity  for  four 
patients  and  cost  $4,000. 


No.  104.  Adirondack  Cottage  Sanitarium, 
Saranac  Lake,  N.  Y.  Scopes  &  Feustmanx. 
Architects.  Wheeler  Cottage.  \'iew  of 
Front  Elevation  and  Floor  Plan.  Capacity, 
4  Patients.  Estimated  Cost,  $4,000.  (See 
illustrations  63.  gS  and  109  for  fiu-thcr  description 
of  this  institution.) 


13/ 


Section  V 


r  ^  s 


*-dir  ^■—■■w 


No.    105. — Gaylord    Farm,  Wallingford,   Conn.     Brow    &   von    Berex,   Architects.     Connected 

Cottages.     \'ie\v  of  Front  and  Side  Elevations  and  Floor  Plans.     Capacity  of 

EACH  Cottage,  8  Patients.     Estimated  Cost,  $3,000. 


■_r--i 


HP=^ 


Gaylord  Farm,  Wallingford,  Conn.,  Connected 

Cottages  (Illustration  105).  These  cottages,  of  frame 
construction,  are  placed  on  stone  foundations  and  stone 
piers  with  cellars  under  the  centres,  and  covered  externally 
with  shingles.  They  are  artistically  and  conveniently  de- 
signed, 35  feet  wide  by  26  feet  deep,  with  a  porch  across 
the  entire  front  and  back,  ten  feet  wide.  The  front  porch 
of  one  cottage  is  connected  with  the  rear  porch  of  the  next 


Qprtr  mRRmnR — 


by  an  open  corridor  40  feet  long  by  13  feet  wide,  which  is 
used  as  a  sleeping  porch  for  patients.  In  the  illustration 
this  corridor  is  shown  ten  feet  wide,  but  it  has  been  broad- 
ened three  feet  in  order  to  give  better  protection  against 
storms. 

There  is  a  sitting  room  in  the  centre,  13  feet  wide 
by  14  feet  deep,  four  patients'  rooms  on  the  sides  10  feet 
wide  by  12  feet  deep,  and  a  room  in  the  rear  9  feet  wide 
by  6  feet  deep,  containing  a  toilet  and  bath.  The  capacity 
is  for  eight  patients  at  an  estimated  cost  of  $4,000. 

158 


Patients'  Quarters — Cottage  Type  of  Building 


No.   io6.     Barlow  Sanatorium,  Los  Angeles,  Cal.     Designed  by  Dr.  W.  Jarvis  Barlow. 
Cottage.     View  of  I'roxt  and  Side  Elev.vtigxs  axd  Floor  Plan. 
Capacity,  2  Patients.     Estimated  Cost,  S500. 


Barlow  Sanatorium,  Los  Angeles,  Cal.,  Cottage  (Illustration  106).  This  build- 
ing is  supported  on  stone  piers  and  is  of  frame  construction,  with  a  shingle  roof,  20  feet 
wide  by  12  feet  deep.  There  is  a  five  foot  open  porch  along  the  north  side  and  both  ends; 
the  outside  of  the  cottage  and  the  porch  are  painted  a  seal  brown  and  the  shingles  of  the 

159 


Section  VI 


No.    107. — Portland    Open    Air    Sanatorium,    Portland,    Ore.      Wiiiddkx    & 
Cottage.     \'ie\v  of  Fko.nt  .\nu  Side  Kle\  atiux  am:)  1\  iickkir.     C" ai'ac  itv,  2  P 
Cost,  $1,000.     (See  illustrations  8  and  16  for  furlluT  desi  riiilion  of  ihis 

160 


Lewis,    Architects 
\tients.     Kstimated 
institution.) 


Patients'  Quarters — Cottage  Type  of  Building 


roof,  green.  The  interior  is  finished  in  surface  lumber  dressed  with  oil  and  varnished, 
but  not  ceiled,  and  is  divided  into  two  rooms  each  lo  feet  wide  by  12  feet  deep.  The  par- 
tition runs  transversely  from  the  floor  to  the  roof  and  is  plain,  but  pierced  by  a  door  which 
may  be  used  if  necessary.  The  north  side  of  the  cottage  is  boarded  up  but  can  be  opened 
by  a  hinged  window.  Each  end  and  the  south  side  are  boarded  to  a  height  of  three  feet 
from  the  floor,  the  space  above  this  to  the  plate  being  protected  by  copper  wire  screening, 
and  pro\ided  with  awnings  which  can  be  let  down  in  wet  weather.  The  doors,  the  space 
between  the  rafters  and  three  inches  under  the  eaves  on  each  side,  left  open  for  ventilation, 
are  screened.  On  the  roof  o\'er  the  partition  is  an  iron  ventilator  sixteen  inches  in 
diameter.  The  toilet  room  is  placed  in  a  small  separate  building  at  the  rear  and  divided 
into  bath,  dressing  and  toilet  rooms,  well  screened  and  ventilated.  This  is  a  good  plan 
where  earth  closets  are  used,  as  they  can  be  emptied  without  disturbing  the  patients. 
Warm  water  is  supplied  for  toilet  purposes  by  a  contrivance  operated  very  successfully 
in  southern  California,  all  the  year  round  by  direct  sunlight,  which  is  called  a  "solar 
heater"  and  is  placed  on  the  roof.  The  capacity  of  the  cottages  is  two  patients  and  it 
cost,  including  toilet,  $700.00. 

The  Open  Air  Sanatorium,  Portland,  Ore.,  Cottage  (Illustration  107).  This 
building  is  placed  on  stone  piers  and  is  of  frame  construction,  externally  covered  with 
stained  shingles  and  trimmed  wnth  white.  It  is  16  feet  wide  by  21  feet  deep  and  has  a 
floor  raised  two  and  a  half  feet  above  the  ground  to  produce  an  air  space,  which  is  en- 
closed with  lattice  work.  The  interior  is  divided  into  an  open  room  16  feet  wide  by  13 
feet  deep,  a  bath  room  4  feet  wide  by  8  feet  long,  a  little  hall  and  two  closets  both  4  feet 
wide  by  3  feet  deep.  It  is  nicely  finished  in  hard  wood  and  sealed  with  narrow,  selected 
boards.  There  is  an  air  space  between  the  ceiling  and  the  roof,  in  order  to  prevent  the 
direct  rays  of  the  sun  heating  the  interior  during  the  middle  of  the  day.  Both  the  air 
space  under  the  floor  and  that  above  the  ceiling  should  be  noted,  as  they  are  a  neces- 
sary part  of  cottage  construction  in  damp  or  hot  countries.  A  number  of  these  cot- 
tages have  been  built  and  are  said  to  be  very  comfortable,  being  classed  with  the  more 
substantial  type  of  open  air  buildings,  as  the  cost  of  construction  was  about  Si, 000. 

Loomis  Sanatorium,  Liberty,  N.  Y.,  The  Orchard  Cottage  (Illustration  108). 
This  building  is  placed  on  a  stone  foundation,  one  story  high  and  of  frame  construction 
covered  externally  and  roofed  with  shingles.  The  interior  is  finished  in  plaster  on  wooden 
lath,  with  hard  wood  floors  and  cypress  trimmings.  It  is  heated  by  direct  radiation  in  the 
rooms,  from  a  hot  water  boiler  placed  in  the  cellar  which  has  been  excavated  under  the 
entire  building.  The  bedrooms  are  about  9  feet  wide  by  10  feet  deep,  made  small  inten- 
tionally to  encourage  the  patients  to  live  on  the  porches.  The  plan  is  of  interest  and  will 
please  those  who  believe  in  utilizing  corners  and  other  small  places.  There  is  a  commodious 
attic  which  can  be  divided  into  se\-eral  rooms,  a  small  combined  living  and  drawing  room 
12  feet  wide  by  18  feet  long,  which  has  a  large  fireplace,  a  kitchen  10  feet  wide  by  11  feet 
long,  a  bath  and  a  maid's  room.  The  cottage  is  more  like  a  pleasant  country  house  than 
an  institutional  building  and  has  a  capacity  for  four  patients  or  a  small  family  and  can  be 
built  at  a  cost  of  about  $3,500. 

Adirondack  Cottage  Sanitarium,  Saranac  Lake,  N.  Y.,  The  Xathax  Cottage 
(Illustration  loq).  This  building  is  of  frame  construction,  covered  externally  with  yellow 
terra-cotta  brick  veneer  placed  on  native  stone  foundation.  The  cottage  is  about  42  feet 
wide  by  30  feet  deep,  with  a  \'cranda  ha\'ing  a  southern  exposure,  and  protected  by  glass 
and  sash  frames  on  the  north,  east  and  west,  arranged  so  that  its  roof  does  not  prevent 
sunlight  from  entering  the  rooms.     The  sitting  room,  14  feet  wide  by  20  feet  deep,  is 

TI  •  l6l 


Section  VT 


No.  io8.— Loomis  Sanatorium,  Liberty,  N.  Y.    Scopes  &  Felstmaw,  Architects.     Orchard  Cottage. 

\iEW  OF  Frdxt  and  Side  J'^lex  ations  and  Floor  Plax.     Capacity,  4  Patients.     Estimated  Cost. 

83,200.     (See  illustrations  i,  72,  73  and  91  for  further  description  of  this  institution.) 

162 


Patients'  Quarters — Cottage  Type  of  Building 


No.  lOQ.— Adirondack  Cottage  Sanitarium,  Saranac  Lake,  N.  Y.  Scopes  &  Feustmaxx,  Architects. 
Nathax  Cuttage.  \ie\v  of  Front  Elevation  and  Floor  Plan.  Capacity.  4  Patients. 
Estimated  Cost,  $5,000.  (See  illustrations  63,  98  and  104  for  further  description  of  this  institu- 
tion.) 


placed  in  the  rear  of  the  Iniilding  and  reached  by  a  hall  from  the  front  door;  there  arc  two 
bedrooms  12  feet  wide  Ijy  10  feet  deep  on  either  side  of  the  hall  and  two  14  feet  wide  by 
10  feet  deep  at  the  sides  of  the  sitting  room,  a  combination  door  and  window  opening.  The 
building  is  ventilated  by  transoms  and  all  windows  and  doors  are  brought  flush  with  the 
ceiling.  Each  bedroom  is  heated  and  has  a  large  closet.  The  cottage  will  accommodate 
four  persons,  and  cost,  including  furnishing,  $5,000. 

163 


Section  \l 


ri(i-3T  rL00J3   PL  AM 

No.  no.— River  Pines   Sanatorium,  Stevens  Point,  Wis.     Designed  by  Dr.  H.  E.  Dearholt. 

Cottage,     \ie\v  of  Front  axd  Side  Ele\atioxs  axd  Floor  Plan. 

Capacity,  8  Patients.     Cost,  $4,000. 


'River  Pines  Cottage  Sanatorium,  Stevens  Point,  Wis.  (Illustration  no). 
This  cottage  is  64  feet  wide  by  30  feet  deep,  of  frame  construction,  with  a  shingle  roof 
and  is  placed  on  a  brick  foundation.  It  has  two  floors,  both  planned  alike,  and  the  arrange- 
ment of  the  rooms  and  porches  is  interesting.  Each  patient  is  supplied  with  a  iinvate 
room  about  twelve  feet  square,  a  closet  and  a  sleeping  porch  about  nine  feet  square,  having 
two  exposures,  one  south  and  the  other  either  east  or  west,  the  porches  being  arranged 
so  that  some  portion  of  them  cannot  be  overlooked  from  other  parts  of  the  buildmg. 
The  bathroom,  toilet,  lavatory  and  main  entrances  are  placed  on  the  north  and  con- 
nected with  all  the  rooms  by  a  small  hall. 

The  cottage  has  a  capacity  for  eight  patients  and  the  estimated  cost  is  $4,000. 

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